Individual provider Active NPI

Randall Nall, MD

  • Internal Medicine Physician
  • Saginaw, MI
National Provider Identifier
1831696772
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301505546 Issued in MI
Practice address
2429 Trautner Dr
Saginaw, MI 48604-9596
Phone
(989) 790-3697
Fax
(989) 583-1742
NPI assigned
Apr 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 72274 WI
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 4301505546 MI Primary

Addresses

Primary practice location

2429 Trautner Dr
Saginaw, MI 48604-9596

Mailing address

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210816001476 MI Practitioner - Internal Medicine 0749537827 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
72274WIMDInternal Medicine Physician
7304WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc Internal Medicine CurrentSince Aug 13, 2021 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients

Locations

12675 E Washington Rd
Reese, MI 48757
Phone (517) 868-4144

2429 Trautner Dr
Saginaw, MI 48604
Phone (989) 790-3697

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

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": "1523145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1831696772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-583-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2429 TRAUTNER DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486049596",
            "telephone_number": "989-790-3697",
            "fax_number": "989-583-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALL",
        "first_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-08",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "72274",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301505546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.