Active NPI
Miakish Randall
- Psychologist
- Jacksonville, FL
National Provider Identifier
1861149403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 1536 N Jefferson St
Jacksonville, FL 32209-6525 - Phone
- (904) 470-6900
- NPI assigned
- Mar 3, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
1536 N Jefferson St
Jacksonville, FL 32209-6525
Mailing address
6900 Southpoint Dr N FL 5
Jacksonville, FL 32216-8007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2843 Percy Rd
Jacksonville, FL 32218-2333
433 Plaza Real
Suite 275
Boca Raton, FL 33432-3932
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646956800000",
"number": "1861149403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6900 SOUTHPOINT DR N FL 5",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1536 N JEFFERSON ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322096525",
"telephone_number": "904-470-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "MIAKISH",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-03",
"last_updated": "2022-03-11",
"certification_date": "2022-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.