Active NPI
Randall Eugene Lakes, RN
- Pain Management Registered Nurse
- Dayton, OH
National Provider Identifier
1689808396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Management Registered Nurse
- License
- RN268482
- Practice address
- 30 E Apple St
Suite 5250
Dayton, OH 45409-2939 - Phone
- (937) 208-7723
- Fax
- (937) 208-3855
- NPI assigned
- May 8, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pain Management Registered Nurse | 163WP0000X | RN268482 | OH | Primary |
Addresses
Primary practice location
30 E Apple St
Suite 5250
Dayton, OH 45409-2939
Mailing address
30 E Apple St
Suite 5250
Dayton, OH 45409-2939
Phone (937) 208-7723
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN268482 | OH | MD | Pain Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241740800000",
"number": "1689808396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 E APPLE ST",
"address_2": "SUITE 5250",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092939",
"telephone_number": "937-208-7723",
"fax_number": "937-208-3855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E APPLE ST",
"address_2": "SUITE 5250",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092939",
"telephone_number": "937-208-7723",
"fax_number": "937-208-3855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKES",
"first_name": "RANDALL",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-08",
"last_updated": "2009-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pain Management",
"state": "OH",
"license": "RN268482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.