Randall Evert Lawson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-019857 Issued in IL

Practice address

505 W College Ave
Jacksonville, IL 62650-2405

Phone

(217) 245-5319

Fax

(217) 291-0219

NPI assigned

Feb 1, 2006

Last updated

Jan 31, 2018By the provider in NPPES

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• College Avenue Dental Sleep Appliances LTD.

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, IL
  • NPI 1962829366
  NPD Authorized official
• Smalltown Dental Jacksonville PLLC

  • General Practice Dentistry
  • Jacksonville, IL
  • NPI 1043127707
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1730151176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 W COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502405",
            "telephone_number": "217-245-5319",
            "fax_number": "217-291-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502405",
            "telephone_number": "217-245-5319",
            "fax_number": "217-291-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "RANDALL",
        "middle_name": "EVERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-019857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette Kutz Schippel, D.C.
• Jessica Landon
• Jamie Lee Landsverk, FNP-BC
• Bryan M Langan, ATC
• Terese J Laughlin, DPM
• Catherine Marie Lay
• Donna Marie Leischner, CERTIFIED NURSE PRAC
• Liberty Counseling Center, Inc
• Lice Police Inc (Lice Clinics of America - Jacksonville)
• Diane M. Lietz, APRN FNP-C

• General Practice Dentistry in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.