Active NPI
Karen A. Randall, D.O.
- Emergency Medicine Physician
- Pueblo, CO
National Provider Identifier
1811061328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 5101010551
- Practice address
- 400 W 16TH St
Pueblo, CO 81003-2745 - Phone
- (719) 584-4306
- Fax
- (719) 595-7886
- NPI assigned
- Nov 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101010551 | MI | |
| Emergency Medicine Physician | 207P00000X | DR.0051971 | CO | |
| Emergency Medicine Physician | 207P00000X | 5101010551 | MI | Primary |
Addresses
Primary practice location
400 W 16TH St
Pueblo, CO 81003-2745
Mailing address
400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4306
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010H262530 | Other | BLUE CROSS-BLUE CROSS | |
| 327179611 | Medicaid | MI | |
| KR010551 | Other | COMMERCIAL-COMMERCIAL NUMBER | |
| KR010551 | Other | CHAMPUS-CHAMPUS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 77.65 of 100
- Quality
- 64.78
- Improvement activities
- 40
- Cost
- 70.76
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0051971 | CO | MD | Emergency Medicine Physician |
| 5101010551 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Colorado Emergency Medical Associates | Emergency Medicine | Current | Accepting new patients |
| Southern Colorado Emergency Medical Associates | Emergency Medicine | Current | Accepting new patients |
| Independent Emergency Physicians, P.C. | Past | Accepting new patients |
Locations
400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000
899 E Industrial Blvd
Pueblo West, CO 81007
Phone (719) 288-2100
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Pueblo, CO
- NPI 1811793904
-
- Emergency Medicine Physician
- Pueblo West, CO
- NPI 1861298960
-
- Emergency Medical Services (Emergency Medicine) Physician
- Southfield, MI
- NPI 1780791343
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384128000000",
"number": "1811061328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 W 16TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032745",
"telephone_number": "719-584-4306",
"fax_number": "719-595-7886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W 16TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032745",
"telephone_number": "719-584-4306",
"fax_number": "719-595-7886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "KAREN",
"middle_name": "A.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-17",
"last_updated": "2013-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101010551",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "DR.0051971",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "5101010551",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-BLUE CROSS",
"identifier": "010H262530",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "327179611",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL-COMMERCIAL NUMBER",
"identifier": "KR010551",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS-CHAMPUS",
"identifier": "KR010551",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; 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.