Randy E Waddell

Primary specialty

OptometristTaxonomy code 152W00000X

License

133T Issued in WY

Practice address

426 Greybull Ave
Greybull, WY 82426-2037

Phone

(307) 765-2998

Fax

(307) 765-2614

NPI assigned

Jul 22, 2005

Sex

Male

Sole proprietor

Yes

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

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eye Care for You, LLC

  • Optometrist
  • Greybull, WY
  • NPI 1487067229
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1679573380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 GREYBULL AVE",
            "city": "GREYBULL",
            "state": "WY",
            "postal_code": "824262037",
            "telephone_number": "307-765-2998",
            "fax_number": "307-765-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 GREYBULL AVE",
            "city": "GREYBULL",
            "state": "WY",
            "postal_code": "824262037",
            "telephone_number": "307-765-2998",
            "fax_number": "307-765-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "RANDY",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "133T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kunkel Sloan
• Makyela Dawn Sorensen, PA-C
• Nickolas Shawn Sullivan-Kern
• Brandon Winters Tolman, PHARMD
• Julie C. Vanderploeg, L.P.C.
• Darcie N Wisehart, MSW, LCSW
• Wyo Clinic LLC

• Optometrist in Greybull, WY
• Providers in Greybull, WY by specialty
• Optometrist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.