Randall Jon Cousins, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27678 Issued in MN

Practice address

2000 Plymouth Rd
Suite 100
Minnetonka, MN 55305-2366

Phone

(763) 581-5250

Fax

(763) 581-5257

NPI assigned

Dec 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Randy Jon Cousins Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378080000000",
    "number": "1962486712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PLYMOUTH RD",
            "address_2": "SUITE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052366",
            "telephone_number": "763-581-5250",
            "fax_number": "763-581-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PLYMOUTH RD",
            "address_2": "SUITE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052366",
            "telephone_number": "763-581-5250",
            "fax_number": "763-581-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINS",
        "first_name": "RANDALL",
        "middle_name": "JON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2013-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "27678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "631570400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDY",
            "last_name": "COUSINS",
            "middle_name": "JON",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Family Medicine Physician in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2013; 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.