Individual provider Active NPI

Randall Lynn York, FNP

  • Family Nurse Practitioner
  • Waco, TX
National Provider Identifier
1740261395
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
640043 Issued in TX
Practice address
1600 Providence Dr
Waco, TX 76707-2261
Phone
(254) 313-4200
Fax
(254) 313-4531
NPI assigned
Nov 10, 2005
Last updated
Apr 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 640043 TX Primary

Addresses

Primary practice location

1600 Providence Dr
Waco, TX 76707-2261

Mailing address

1600 Providence Dr
Waco, TX 76707-2261
Phone (254) 313-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050718000811 TX Practitioner - Nurse Practitioner 4688601016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 Providence Dr
Waco, TX 76707-2261
Phone (254) 313-4200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
640043TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Texas Community Health Center Inc Current Accepting new patients
Heart of Texas Community Health Center, Inc. CurrentSince May 29, 2018 Accepting new patients
Heart of Texas Community Health Center, Inc CurrentSince May 29, 2018 Accepting new patients
E T Nephrology Associates Past Accepting new patients
Waco Lung Associates PA Past Accepting new patients

Locations

1600 Providence Dr
Waco, TX 76707
Phone (254) 313-4200

7125 Sanger Rd
Ste B
Woodway, TX 76712
Phone (254) 741-1688

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1740261395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORK",
        "first_name": "RANDALL",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "640043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.