Kelly R Randall, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

119887-30 Issued in WI

Practice address

200 W Alona LN
Lancaster, WI 53813-2202

Phone

(608) 723-6357

Fax

(608) 723-4417

NPI assigned

Jan 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1669719639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ALONA LN",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538132202",
            "telephone_number": "608-723-6357",
            "fax_number": "608-723-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ALONA LN",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538132202",
            "telephone_number": "608-723-6357",
            "fax_number": "608-723-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "119887-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly A Perttu, DO
• Physician Management Services of Wisconsin, LLC
• Stacey M Place, PT
• Abby Price
• Sajid Hafeez Qazi, D.O.
• Abby Rasmussen, DPT
• David Gerard Recker, MA, LAT, CSCS
• Katherine C Reuter, APNP
• Barbara A Ritchie, OTR
• Tracy M Roesch

• All providers in Lancaster, WI
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; 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.