Randy J Tarvin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD 111602 Issued in MO

Practice address

1741 NE Douglas St
Suite 200
Lees Summit, MO 64086-4703

Phone

(816) 246-0200

Fax

(816) 246-0220

NPI assigned

Sep 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Summit Medical Associates LLC

  • Family Medicine Physician
  • Lees Summit, MO
  • NPI 1699718338
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1952396905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 MARSHALL DR",
            "address_2": "SUITE 220",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141505",
            "telephone_number": "816-246-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 NE DOUGLAS ST",
            "address_2": "SUITE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640864703",
            "telephone_number": "816-246-0200",
            "fax_number": "816-246-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARVIN",
        "first_name": "RANDY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "MD 111602",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0422753",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmed Sidiya Taleb Abdellah, M.D
• Kelly Talley, COTA
• Donald Edwin Tanner, FNP-C
• Marc Kenneth Taormina, MD
• Saad Masood Tarar
• Brianda L Taylor, PHARMD
• Crystal Dianne Taylor, DO
• Isis Taylor
• Jennifer Rebecca Taylor, LMSW
• Laurice Michelle Taylor, LPC

• Family Medicine Physician in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.