Individual provider Active NPI

Abigail Randecker, RD, LD

  • Registered Dietitian
  • San Antonio, TX
National Provider Identifier
1811883317
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86359197 Issued in TX
Practice address
326 S Flores St Apt 2042
San Antonio, TX 78204-1036
Phone
(832) 458-7663
NPI assigned
Jun 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86359197 TX Primary

Addresses

Primary practice location

326 S Flores St Apt 2042
San Antonio, TX 78204-1036

Mailing address

326 S Flores St Apt 2042
San Antonio, TX 78204-1036
Phone (832) 458-7663

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250718004249 TX Practitioner - Psychiatry 4880100635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86359197TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Camino Real Community MHMR Center CurrentSince Jun 10, 2025 Accepting new patients
Camino Real Community MHMR Center Past Accepting new patients

Locations

1749 E State Highway 97
Jourdanton, TX 78026
Phone (830) 767-2320

19965 FM 3175
Lytle, TX 78052
Phone (210) 357-0300

Organizations & group practices 2

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": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1811883317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 S FLORES ST APT 2042",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782041036",
            "telephone_number": "832-458-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 S FLORES ST APT 2042",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782041036",
            "telephone_number": "832-458-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDECKER",
        "first_name": "ABIGAIL",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "86359197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.