Crista Randol, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71009114A Issued in IN

Practice address

7333 W Jefferson Blvd
Fort Wayne, IN 46804-6280

Phone

(260) 458-3825

NPI assigned

Jul 10, 2019

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

Enrolled in KY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Brock Medical, LLC

  • Nurse Practitioner
  • London, KY
  • NPI 1023379815
  Medicare reassignment NPD
• Fast Pace Kentucky PLLC

  • Family Nurse Practitioner
  • Franklin, KY
  • NPI 1457716706
  Medicare reassignment NPD
• Fast Pace Kentucky PLLC

  • Rural Health Clinic/Center
  • Corbin, KY
  • NPI 1669256913
  NPD
• Fast Pace Kentucky, PLLC

  • Rural Health Clinic/Center
  • Spindale, NC
  • NPI 1942027891
  NPD
• Fast Pace Kentucky, PLLC

  • Rural Health Clinic/Center
  • Bardstown, KY
  • NPI 1184381444
  NPD (past)

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1689226797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 SURREY CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468158777",
            "telephone_number": "260-450-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7333 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046280",
            "telephone_number": "260-458-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOL",
        "first_name": "CRISTA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009114A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark C Ranck, M.D.
• David Randall
• Stacy Randall
• Brooke Randol, MSN, RN, AGCNS-BC
• Colette Randol, MSW
• Randolph Dialysis LLC
• Geoffrey M Randolph, MD
• Jesse Marie Randolph
• Armando Rangel Jr., R.D.
• Rachel L Rankin, RBT

• Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.