Active NPI
Randall E Woesner, MD
- Ophthalmology Physician
- Ukiah, CA
National Provider Identifier
1679569933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- G44111
- Practice address
- 248-A Hospital Dr
Ukiah, CA 95482-4555 - Phone
- (707) 463-1659
- Fax
- (707) 463-2195
- NPI assigned
- Sep 22, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | G44111 | CA | Primary |
Addresses
Primary practice location
248-A Hospital Dr
Ukiah, CA 95482-4555
Mailing address
248-A Hospital Dr
Ukiah, CA 95482-4555
Phone (707) 463-1659
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G441110 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G44111 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1679569933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248-A HOSPITAL DR",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824555",
"telephone_number": "707-463-1659",
"fax_number": "707-463-2195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "248-A HOSPITAL DR",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824555",
"telephone_number": "707-463-1659",
"fax_number": "707-463-2195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOESNER",
"first_name": "RANDALL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "G44111",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G441110",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.