Individual provider Active NPI

Randy Roman, DC

  • Chiropractor
  • Grand Junction, CO
National Provider Identifier
1659490910
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4818 Issued in CO
Practice address
2584 Patterson Rd Suite D
Grand Junction, CO 81505
Phone
(970) 243-8896
Fax
(970) 245-1511
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4818 CO Primary

Addresses

Primary practice location

2584 Patterson Rd Suite D
Grand Junction, CO 81505

Mailing address

2584 Patterson Rd Suite D
Grand Junction, CO 81505-1445
Phone (970) 243-8896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421000027 CO Practitioner - Chiropractic 2062408735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2584 Patterson Rd
Suite D
Grand Junction, CO 81505-1452
Phone (970) 243-8896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4818COMDChiropractor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1659490910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2584 PATTERSON RD SUITE D",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051445",
            "telephone_number": "970-243-8896",
            "fax_number": "970-245-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2584 PATTERSON RD SUITE D",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81505",
            "telephone_number": "970-243-8896",
            "fax_number": "970-245-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "RANDY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "4818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.