Active NPI
Randi Moss, SSP
- School Psychologist
- Conway, SC
National Provider Identifier
1962869834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 4656
- Practice address
- 800 Legion St
Suite 220C
Conway, SC 29526-4825 - Phone
- (843) 468-1850
- NPI assigned
- Jan 24, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 4656 | SC | Primary |
Addresses
Primary practice location
800 Legion St
Suite 220C
Conway, SC 29526-4825
Mailing address
127 Johnstone LN
Georgetown, SC 29440-8555
Phone (518) 469-0758
Other names 1
- Randi Flansburg
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4656 | SC | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453593600000",
"number": "1962869834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 JOHNSTONE LN",
"city": "GEORGETOWN",
"state": "SC",
"postal_code": "294408555",
"telephone_number": "518-469-0758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 LEGION ST",
"address_2": "SUITE 220C",
"city": "CONWAY",
"state": "SC",
"postal_code": "295264825",
"telephone_number": "843-468-1850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "RANDI",
"credential": "SSP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-24",
"last_updated": "2016-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "SC",
"license": "4656",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RANDI",
"last_name": "FLANSBURG",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.