Individual provider Active NPI

Randall Lee Holyfield Jr., HAD

  • Hearing Instrument Specialist
  • Fort Collins, CO
National Provider Identifier
1790579274
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HAD.0000575 Issued in CO
Practice address
2601 S Lemay Ave Unit 41
Fort Collins, CO 80525-2297
Phone
(970) 286-2607
NPI assigned
Apr 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HAD.0000575 CO Primary

Addresses

Primary practice location

2601 S Lemay Ave Unit 41
Fort Collins, CO 80525-2297

Mailing address

2601 S Lemay Ave Unit 41
Fort Collins, CO 80525-2297
Phone (970) 286-2607

Other names 1

  • Randy Lee Holyfield Jr. Other name

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

State licenses

LicenseStateTypeSpecialty
HAD.0000575COMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
MLM USA LLC Audiologist-Hearing Aid Fitter Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1790579274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 S LEMAY AVE UNIT 41",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252297",
            "telephone_number": "970-286-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 S LEMAY AVE UNIT 41",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252297",
            "telephone_number": "970-286-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLYFIELD",
        "first_name": "RANDALL",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "HAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CO",
            "license": "HAD.0000575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDY",
            "last_name": "HOLYFIELD",
            "middle_name": "LEE",
            "suffix": "JR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.