Individual provider Active NPI

Randall Scott Rohmiller, DDS

  • General Practice Dentistry
  • Joplin, MO
National Provider Identifier
1689731358
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEO15268 Issued in MO
Practice address
2700 MC Clelland Blvd
Suite 206
Joplin, MO 64804-1623
Phone
(417) 782-7810
Fax
(417) 782-7805
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEO15268 MO Primary

Addresses

Primary practice location

2700 MC Clelland Blvd
Suite 206
Joplin, MO 64804-1623

Mailing address

2700 MC Clelland Blvd
Suite 206
Joplin, MO 64804-1623
Phone (417) 782-7810

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEO15268MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689731358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 MC CLELLAND BLVD",
            "address_2": "SUITE 206",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041623",
            "telephone_number": "417-782-7810",
            "fax_number": "417-782-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MC CLELLAND BLVD",
            "address_2": "SUITE 206",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041623",
            "telephone_number": "417-782-7810",
            "fax_number": "417-782-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHMILLER",
        "first_name": "RANDALL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "DEO15268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.