Individual provider Active NPI

Kristin Anne Randall, PHARM.D.

  • Pharmacist
  • Stoughton, MA
National Provider Identifier
1659714616
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
69592 Issued in TX
Practice address
100 Technology Center Dr
Stoughton, MA 02072-4710
Phone
(781) 566-5066
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19460 CO
Pharmacist 183500000X 69592 TX Primary

Addresses

Primary practice location

100 Technology Center Dr
Stoughton, MA 02072-4710

Mailing address

9277 Tundra Swan LN
Littleton, CO 80125-8485
Phone (720) 837-3979

Other identifiers 2

IdentifierTypeStateIssuer
19460OtherCOCO PHARMACIST LICENSE
69592OtherTXTX PHARMACIST LICENSE

Other names 1

  • Dr. Kristin Anne Walsh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19460COMDPharmacist
69592TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dillon Companies LLC PastSince Oct 1, 2020 Accepting new patients
Dillon Companies LLC Past Accepting new patients
Dillon Companies LLC PastSince Oct 1, 2020 Accepting new patients
Rio Grande Urology PA PastSince Feb 7, 2022 Accepting new patients

Organizations & group practices 4

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1659714616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9277 TUNDRA SWAN LN",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801258485",
            "telephone_number": "720-837-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TECHNOLOGY CENTER DR",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020724710",
            "telephone_number": "781-566-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "KRISTIN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "19460",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "69592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO PHARMACIST LICENSE",
            "identifier": "19460",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX PHARMACIST LICENSE",
            "identifier": "69592",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "WALSH",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stoughton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.