Randa Deanne Roddy, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041337855 Issued in IL

Practice address

14410 Route 37
Johnston City, IL 62951-3166

Phone

(618) 983-6911

NPI assigned

Nov 7, 2012

Last updated

Nov 7, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Randa Deanne Youngblood Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1922352350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "628220155",
            "telephone_number": "618-724-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14410 ROUTE 37",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629513166",
            "telephone_number": "618-983-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDY",
        "first_name": "RANDA",
        "middle_name": "DEANNE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041337855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDA",
            "last_name": "YOUNGBLOOD",
            "middle_name": "DEANNE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Betty Jane Payne, LPN
• Carrie Payne, LPN
• Christa S Pestka, MD
• Amy Potts, LPN
• Kayce E Rametta, LPN
• Betty L Rucker, LPN
• Jacob Schlee, D.D.S.
• Rebecca Schlee, DDS
• Shawnee Health Service and Development Corp (Washington Middle School Health Center)
• Shawnee Health Service and Development Corp (Jefferson Elementary School Health Center)

• Registered Nurse in Johnston City, IL
• Providers in Johnston City, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.