Iridescent Wellness Clinic PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

IRIDESCENT WELLNESS CLINIC PC

Practice address

1907 Garden Ave Ste 203
Eugene, OR 97403-1965

Phone

(503) 739-5705

NPI assigned

May 10, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Randa Jill Kucey, DNPNPI 1871905620

Title

FNP/Owner

Phone

(503) 739-5705

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randa Jill Kucey, FNP

  • Family Nurse Practitioner
  • Eugene, OR
  • NPI 1871905620
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1770167348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 W 28TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974051426",
            "telephone_number": "503-739-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 GARDEN AVE STE 203",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031965",
            "telephone_number": "503-739-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRIDESCENT WELLNESS CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-10",
        "status": "A",
        "authorized_official_last_name": "KUCEY",
        "authorized_official_first_name": "RANDA",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "FNP/OWNER",
        "authorized_official_telephone_number": "503-739-5705",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Iridescentwellness.org",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Direct messaging",
            "address_1": "2312 W 28th Ave",
            "city": "Eugene",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974051426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Interplay PC
• Invictus Therapy and Consultation LLC
• Joseph Michael Ippolito, OTR/L
• Dainis Irbe, M.D.
• Hira Irfan
• Taylor Irvin
• Tiffany Irwin, LPC
• Craig William Iseli, DPT
• McKenzie Sky Isham
• Rudy Lei Ishibashi

• Family Nurse Practitioner in Eugene, OR
• Providers in Eugene, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.