Individual provider Active NPI

Kati Louise Randell

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1801195672
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
IC-1269 Issued in NV
Practice address
7380 Atwood Ave
Las Vegas, NV 89129
Phone
(702) 468-4946
NPI assigned
Mar 19, 2011
Last updated
Aug 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IC-1269 NV Primary
Rehabilitation Practitioner 225400000X NU

Addresses

Primary practice location

7380 Atwood Ave
Las Vegas, NV 89129

Mailing address

7380 Atwood Ave
Las Vegas, NV 89129-6222
Phone (702) 468-4946

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240712003345 TX Practitioner - Clinical Social Worker 3870038979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TP-Health IncorporatedGroup PAC ID 4486089950, 14 clinicians

Practice addresses (Care Compare)

4810 Riverstone Blvd
Suite 100
Missouri City, TX 77459-4092
Phone (832) 916-2677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IC-1269NVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
TP-Health Incorporated Single Specialty CurrentSince May 3, 2024 Accepting new patients

Locations

4810 Riverstone Blvd
Ste 100
Missouri City, TX 77459
Phone (832) 916-2677

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1300492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1801195672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7380 ATWOOD AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296222",
            "telephone_number": "702-468-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7380 ATWOOD AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89129",
            "telephone_number": "702-468-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDELL",
        "first_name": "KATI",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-19",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "IC-1269",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.