Andrea M Randall, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71004999A Issued in IN

Practice address

8402 Harcourt Rd Ste 615
Indianapolis, IN 46260-2055

Phone

(317) 806-6991

Fax

(317) 806-6990

NPI assigned

May 16, 2014

Last updated

Mar 25, 2021By the provider in NPPES

Sex

Female

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 1

Other names 1

• Andrea Woodsmall Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Josephson-Wallack-Munshower Neurology PCGroup PAC ID 6709868870, 59 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• Riverview Health Hospital, Noblesville, IN, CCN 150059
• Ascension St Vincent Fishers Hospital, Fishers, IN, CCN 150181
• Community Hospital North Hospital, Indianapolis, IN, CCN 150169

Merit-based Incentive Payment System (MIPS)

Final score

69.89 of 100Reported as group

Promoting interoperability

56

Improvement activities

40

Cost

76.39

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1753
• Direct secure messaging: arandall@jwmn.gwaydirect.com

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.

• Josephson-Wallack-Munshower Neurology PC

  dba JWM Neurology PC

  • Neurology Physician
  • Indianapolis, IN
  • NPI 1740377803
  Medicare reassignment Care Compare group NPD
• Indiana Polyclinic PC

  • Pain Clinic/Center
  • Carmel, IN
  • NPI 1609117118
  Medicare reassignment NPD
• Josephson-Wallack-Munshower Neurology PC

  dba JWM Neurology PC

  • Neurology Physician
  • Indianapolis, IN
  • NPI 1538119219
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1619163854
  Care Compare affiliation
• Riverview Hospital

  • General Acute Care Hospital
  • Noblesville, IN
  • NPI 1700883717
  Care Compare affiliation
• St Vincent Fishers Hospital Inc

  dba Ascension St Vincent Fishers

  • General Acute Care Hospital
  • Fishers, IN
  • NPI 1881956167
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent Hospital

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent - Avon

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1821409467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6983 HILLSDALE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502054",
            "telephone_number": "317-849-8350",
            "fax_number": "317-576-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 HARCOURT RD STE 615",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602055",
            "telephone_number": "317-806-6991",
            "fax_number": "317-806-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "ANDREA",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28179360A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28179360A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004999A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000001082384",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referrals@jwmn.gwaydirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8402 Harcourt Rd Ste 615",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462602055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "WOODSMALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grant Edward Ranchoff
• Elena Marie Rand-Ready, PA-C
• Alexa Rand
• Jessica Marie Rand, RN
• Kevin Lee Rand, PH.D.
• Ann Mathilde Randall, O.T.R.
• Emily Marie Randall, P.A.
• Jacqueline Randall
• Karen Kay Randall, RD
• Maeve Randall

• Family Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.