Organization Active NPI

Randy J. Fearing, DC

  • Chiropractor
  • Gainesville, FL
National Provider Identifier
1669657185
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH2440 Issued in FL
Legal business name
RANDY J. FEARING, DC
Practice address
4509 NW 23Rd Ave
Suite 6
Gainesville, FL 32606-6570
Phone
(352) 377-5158
Fax
(352) 377-4303
NPI assigned
Jan 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Authorized official

Name
Dr. Randy J. Fearing, D. C.NPI 1104806579
Title
Owner
Phone
(352) 377-5158

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH2440 FL Primary

Addresses

Primary practice location

4509 NW 23Rd Ave
Suite 6
Gainesville, FL 32606-6570

Mailing address

4509 NW 23Rd Ave
Suite 6
Gainesville, FL 32606-6570
Phone (352) 377-5158

Other identifiers 3

IdentifierTypeStateIssuer
50318500MedicaidFL
CH002440OtherFLFL LICENSE
89904OtherFLBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
Randy J Fearing DC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4509 NW 23rd Ave
Ste 6
Gainesville, FL 32606
Phone (352) 377-5158

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1669657185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 NW 23RD AVE",
            "address_2": "SUITE 6",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066570",
            "telephone_number": "352-377-5158",
            "fax_number": "352-377-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 NW 23RD AVE",
            "address_2": "SUITE 6",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066570",
            "telephone_number": "352-377-5158",
            "fax_number": "352-377-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY J. FEARING, DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "FEARING",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-377-5158",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50318500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE",
            "identifier": "CH002440",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "89904",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.