Randy Devoe Woolf, OPTOMETRIST (OD)

Primary specialty

OptometristTaxonomy code 152W00000X

License

2006TX Issued in WA

Practice address

JC Penney Optical,
4730 N. Division St
Spokane, WA 99207

Phone

(509) 483-4855

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Southern California College of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kyle Sexton, O.D., LLCGroup PAC ID 1951470913, 10 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Kyle Sexton, O.D., LLC

  • Optometrist
  • Puyallup, WA
  • NPI 1972778009
  Medicare reassignment Care Compare group NPD
• Usv Optical Inc.

  • Eyewear Supplier
  • Spokane, WA
  • NPI 1184638454
  NPD (past)
• Usv Optical Inc

  • Eyewear Supplier
  • Blackwood, NJ
  • NPI 1578891008

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699810952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 N ADAMS RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162004",
            "telephone_number": "509-921-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JC PENNEY OPTICAL,",
            "address_2": "4730 N. DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99207",
            "telephone_number": "509-483-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLF",
        "first_name": "RANDY",
        "middle_name": "DEVOE",
        "credential": "OPTOMETRIST (OD)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "2006TX",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "863OD",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS INSURANCE",
            "identifier": "5690WO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED INSURANCE NUMBER",
            "identifier": "919268",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison J Wooldridge, MS, CCC-SLP/L
• Andrew Woolf, D.O
• Jason M Woolf, DMD
• Landon Woolf
• Lexi Lee Woolf
• Charles Hatfield Woolley V, ATC, EMT
• McKenzie Woolley
• Sydney Nicole Woolley, OTR
• Alexandra Woolston
• Anita E Woolway

• Optometrist in Spokane, WA
• Providers in Spokane, WA by specialty
• Optometrist in Washington

• 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.
• 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.