Randall Flanery, PH D

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

R0282 Issued in MO

Practice address

1129 Macklind Ave
Saint Louis, MO 63110-1440

Phone

(314) 534-0200

Fax

(314) 534-7996

NPI assigned

Jan 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760533129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 MACKLIND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101440",
            "telephone_number": "314-534-0200",
            "fax_number": "314-534-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MACKLIND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101440",
            "telephone_number": "314-534-0200",
            "fax_number": "314-534-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANERY",
        "first_name": "RANDALL",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MO",
            "license": "R0282",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Flanagan, PSYD
• Maureen Elizabeth Flanagan, ACNP
• Michelle Flanagan, P.T.
• Molly Ann Flanagan, PLPC
• Patrice Flanagan
• Daniel A Flappan, DO
• Stacy Scharlene Flathers, LPC
• Andrea Flatley, NP
• Thomas C. Flavin, D.D.S.
• Christine Fleagle, CPNP

• Cognitive & Behavioral Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Cognitive & Behavioral Psychologist in Missouri

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.