Randal E Williams, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.0001279 Issued in CO

Practice address

1001 S Perry St
Suite: 101B
Castle Rock, CO 80104-2668

Phone

(303) 688-2228

Fax

(303) 663-0640

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uchealth Highlands Ranch Hospital Hospital, Highlands Ranch, CO, CCN 060132

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Integrity Urgent Care, P.C.

  • Urgent Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1912189788
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Uchealth Highlands Ranch Hospital

  • General Acute Care Hospital
  • Highlands Ranch, CO
  • NPI 1891294518
  Care Compare affiliation

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1811966385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S PERRY ST",
            "address_2": "SUITE: 101B",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042668",
            "telephone_number": "303-688-2228",
            "fax_number": "303-663-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S PERRY ST",
            "address_2": "SUITE: 101B",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801042668",
            "telephone_number": "303-688-2228",
            "fax_number": "303-663-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RANDAL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15-00965",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0001279",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2010-0073",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71577289",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200362810A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95256237",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Williams, M.A. CCC-SLP
• Bradey Michaela Williams, PT, DPT
• Elijah Williams
• Kiersten Wilson Williams, MD
• Kylee Williams
• Brittany Wilson, DC
• Leslie Ann Wilson, SLP-CCC
• Kristen Winter, M.A CCC-SLP
• Pamela Sue Wise, LPC,CPC
• Jackson Wold, PHARMD

• Medical Physician Assistant in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.