Active NPI
Randall K. Winder, O.D.
- Optometrist
- St George, UT
National Provider Identifier
1659462257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 364760-9934
- Practice address
- 835 N 3050 E
Saint George, UT 84790-9041 - Phone
- (435) 256-0012
- Fax
- (435) 256-0013
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 364760-9934 | UT | Primary |
Addresses
Primary practice location
835 N 3050 E
Saint George, UT 84790-9041
Mailing address
PO Box 3043
Saint George, UT 84771-3043
Phone (435) 256-0012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 364760-9934 | Other | UT | UTAH LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 16, 2018 through Jul 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 364760-9934 | UT | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1659462257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3043",
"city": "SAINT GEORGE",
"state": "UT",
"postal_code": "847713043",
"telephone_number": "435-256-0012",
"fax_number": "435-256-0013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 N 3050 E",
"city": "SAINT GEORGE",
"state": "UT",
"postal_code": "847909041",
"telephone_number": "435-256-0012",
"fax_number": "435-256-0013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINDER",
"first_name": "RANDALL",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "UT",
"license": "364760-9934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTAH LICENSE NUMBER",
"identifier": "364760-9934",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.