Judith Myrick Randall, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201250024 Issued in OR

Practice address

1890 Waite St
Ste 1
North Bend, OR 97459-1229

Phone

(541) 756-6232

Fax

(541) 756-6234

NPI assigned

Dec 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Family Home Care Corporation

  • Home Health Agency
  • Liberty Lake, WA
  • NPI 1497951651
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1891978763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 WAITE ST",
            "address_2": "STE 1",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591229",
            "telephone_number": "541-756-6232",
            "fax_number": "541-756-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 WAITE ST",
            "address_2": "STE 1",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591229",
            "telephone_number": "541-756-6232",
            "fax_number": "541-756-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JUDITH",
        "middle_name": "MYRICK",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007876",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201250024",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201250025NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WATERFALL CLINIC, INC. GROUP NPI",
            "identifier": "1619915113",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213342",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN NUMBER",
            "identifier": "R120353",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chris Poor
• Connie Prince
• Hammad Qadir
• R Scott Roberts DDS PC
• Cynthia Ramirez
• Pamela Louise Rangel, QMHA
• Matthew Dagan Reines, HS
• Kait Reisner, B.S.
• Isabel Resendiz Espino, MS CF-SLP BILINGUAL
• Rest, Relax, Recover Therapeutic Massage Center

• All providers in North Bend, OR
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; 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.