Individual provider Active NPI

Randall Zuni, CPSW,BSN

  • Case Manager/Care Coordinator
  • Gallup, NM
National Provider Identifier
1831723899
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
1050 Issued in NM
Practice address
650 Vandenbosch Pkwy
Gallup, NM 87301-5508
Phone
(505) 726-6919
Fax
(505) 726-6937
NPI assigned
Feb 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 1050 NM Primary

Addresses

Primary practice location

650 Vandenbosch Pkwy
Gallup, NM 87301-5508

Mailing address

650 Vandenbosch Pkwy
Gallup, NM 87301-5508
Phone (505) 726-6919

Other identifiers 1

IdentifierTypeStateIssuer
1050OtherNMCERTIFIED PEER SUPPORT WORKER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
1050NMMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehoboth McKinley Christian Health Care Services, Inc PastSince Mar 1, 2020 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc PastSince Mar 1, 2020 Accepting new patients

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": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1831723899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 VANDENBOSCH PKWY",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015508",
            "telephone_number": "505-726-6919",
            "fax_number": "505-726-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 VANDENBOSCH PKWY",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015508",
            "telephone_number": "505-726-6919",
            "fax_number": "505-726-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUNI",
        "first_name": "RANDALL",
        "credential": "CPSW,BSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NM",
            "license": "1050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED PEER SUPPORT WORKER",
            "identifier": "1050",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.