Active NPI
Louis Randall
- Specialist
- Baltimore, MD
National Provider Identifier
1891762183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- D17097
- Practice address
- 3635 Old Court Rd
Suite 405
Baltimore, MD 21208-3915 - Phone
- (410) 484-2700
- NPI assigned
- Mar 5, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | D17097 | MD | Primary |
Addresses
Primary practice location
3635 Old Court Rd
Suite 405
Baltimore, MD 21208-3915
Mailing address
3635 Old Court Rd
Suite 405
Baltimore, MD 21208-3915
Phone (410) 484-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201111000539 | MD | Order and Referring Only - Addiction Medicine | 1052749231 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891762183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3635 OLD COURT RD",
"address_2": "SUITE 405",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212083915",
"telephone_number": "410-484-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3635 OLD COURT RD",
"address_2": "SUITE 405",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212083915",
"telephone_number": "410-484-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "LOUIS",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MD",
"license": "D17097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.