Individual provider Active NPI

Jasmine Randall

  • Licensed Practical Nurse
  • Columbus, OH
National Provider Identifier
1912762105
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
161921 Issued in OH
Practice address
899 E Broad St
Columbus, OH 43205-1156
Phone
(614) 396-9333
NPI assigned
Feb 16, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 161921 OH Primary

Addresses

Primary practice location

899 E Broad St
Columbus, OH 43205-1156

Mailing address

6400 E Broad St
Columbus, OH 43213-2086
Phone (614) 655-3345

Other practice location 1

881 E Main St
Columbus, OH 43205-1713
Phone (614) 253-8537

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

State licenses

LicenseStateTypeSpecialty
161921OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Access Behavioral LLC PastSince Aug 9, 2020 Accepting new patients
Access Behavioral LLC Past Accepting new patients
Main Street Family Medicine ,LLC PastSince Dec 11, 2006 Accepting new patients

Organizations & group practices 3

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": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1912762105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132086",
            "telephone_number": "614-655-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051156",
            "telephone_number": "614-396-9333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "881 E Main St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432051713",
            "country_code": "US",
            "telephone_number": "614-253-8537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JASMINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "161921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.