Individual provider Active NPI

Randall James Nett, MD

  • Family Medicine Physician
  • Fe Warren Afb, WY
National Provider Identifier
1730174343
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01056810A Issued in IN
Practice address
6900 Alden Dr
90 MDG
Fe Warren Afb, WY 82005-3906
Phone
(307) 773-3461
Fax
(307) 773-3809
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01056810A IN Primary

Addresses

Primary practice location

6900 Alden Dr
90 MDG
Fe Warren Afb, WY 82005-3906

Mailing address

6900 Alden Dr
90 MDG Flight Medicine Clinic Sgo Af
Fe Warren Afb, WY 82005-3906
Phone (307) 773-3461

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01056810AINMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730174343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR",
            "address_2": "90 MDG FLIGHT MEDICINE CLINIC SGO AF",
            "city": "FE WARREN AFB",
            "state": "WY",
            "postal_code": "820053906",
            "telephone_number": "307-773-3461",
            "fax_number": "307-773-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR",
            "address_2": "90 MDG",
            "city": "FE WARREN AFB",
            "state": "WY",
            "postal_code": "820053906",
            "telephone_number": "307-773-3461",
            "fax_number": "307-773-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETT",
        "first_name": "RANDALL",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01056810A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fe Warren Afb, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.