Individual provider Active NPI

Randolph W Nordyke, DPM

  • Podiatrist
  • Ventura, CA
National Provider Identifier
1851471700
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4245 Issued in CA
Practice address
4080 Loma Vista Rd
Suite D
Ventura, CA 93003-1811
Phone
(805) 650-8333
Fax
(805) 650-8382
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4245 CA Primary

Addresses

Primary practice location

4080 Loma Vista Rd
Suite D
Ventura, CA 93003-1811

Mailing address

4080 Loma Vista Rd
Suite D
Ventura, CA 93003-1811
Phone (805) 650-8333

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
E4245CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Concepts, Inc Podiatrist PastSince Dec 1, 2014 Accepting new patients

Organizations & group practices 1

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1851471700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 LOMA VISTA RD",
            "address_2": "SUITE D",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031811",
            "telephone_number": "805-650-8333",
            "fax_number": "805-650-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 LOMA VISTA RD",
            "address_2": "SUITE D",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031811",
            "telephone_number": "805-650-8333",
            "fax_number": "805-650-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDYKE",
        "first_name": "RANDOLPH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.