Tyler William Randall

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0994692-NP Issued in CO

Practice address

1338 Phay Ave
Canon City, CO 81212-2311

Phone

(719) 285-2000

NPI assigned

May 24, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, NC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: trandall125033@firsthealth.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• FHPG, LLC

  • Family Medicine Physician
  • Lillington, NC
  • NPI 1760329486
  Medicare reassignment Care Compare group
• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385

  NC, Nurse Practitioner

  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Washington PLLC

  • Emergency Medicine Physician
  • Sedro Woolley, WA
  • NPI 1629532064

  Nurse Practitioner

  Medicare reassignment NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1023285756

  Nurse Practitioner

  Medicare reassignment NPD
• FHPG, LLC

  • Family Medicine Physician
  • Ellerbe, NC
  • NPI 1336154129
  NPD
• FHPG, LLC

  • Specialist
  • Troy, NC
  • NPI 1346279445
  NPD
• FHPG, LLC

  • Family Medicine Physician
  • Sanford, NC
  • NPI 1942196035
  NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1508023789
  NPD
• Peacehealth

  • Rural Acute Care Hospital
  • Bellingham, WA
  • NPI 1487904546
  NPD (past)

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1780241794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911057",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802911057",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 PHAY AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122311",
            "telephone_number": "719-285-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "TYLER",
        "middle_name": "WILLIAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-24",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61177225",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61177225",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0994692-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Anne Rabel, DMD
• Tracey Rafuse, FNP-C
• Ryan S Rahman, M.D.
• Marc-Andre Rameau
• Danielle Rene Ramseier, LPCC
• Becky Rautenberg
• Kris S. Ray, L.C.S.W.
• Maranda Ray, FNP-C
• Reams Palace Drug Inc
• Reams Palace Drug Inc

• Family Nurse Practitioner in Canon City, CO
• Providers in Canon City, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.