Individual provider Active NPI

Neema Tillery Randall, D.C.

  • Chiropractor
  • Sandston, VA
National Provider Identifier
1972522928
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556165 Issued in VA
Practice address
105 W Williamsburg Rd Ste 105
Sandston, VA 23150-1442
Phone
(804) 328-0807
Fax
(804) 328-0809
NPI assigned
Jul 19, 2006
Last updated
May 2, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104556165 VA Primary

Addresses

Primary practice location

105 W Williamsburg Rd Ste 105
Sandston, VA 23150-1442

Mailing address

105 W Williamsburg Rd Ste 105
Sandston, VA 23150-1442
Phone (804) 328-0807

Other identifiers 11

IdentifierTypeStateIssuer
320200738OtherVAANTHEM BCBS
320200738OtherVAVA HEALTH
243793OtherVASOUTHERN HEALTH SERVICES, INC.
320200738OtherVACIGNA
320200738OtherVAUNITED HEALTHCARE
495986OtherVAPHCS
320200738OtherVACHOICE CARE
2212959OtherVAFIRST HEALTH
301890OtherVABCBS
0007828549OtherVAAETNA
1047502OtherVAASHN

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Within, Inc. Current Accepting new patients
Leesburg Chiropractic and Massage, P.L.L.C. Chiropractor PastSince Apr 25, 2013 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1972522928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W WILLIAMSBURG RD STE 105",
            "city": "SANDSTON",
            "state": "VA",
            "postal_code": "231501442",
            "telephone_number": "804-328-0807",
            "fax_number": "804-328-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W WILLIAMSBURG RD STE 105",
            "city": "SANDSTON",
            "state": "VA",
            "postal_code": "231501442",
            "telephone_number": "804-328-0807",
            "fax_number": "804-328-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "NEEMA",
        "middle_name": "TILLERY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "320200738",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA HEALTH",
            "identifier": "320200738",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH SERVICES, INC.",
            "identifier": "243793",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "320200738",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "320200738",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "495986",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICE CARE",
            "identifier": "320200738",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2212959",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "301890",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007828549",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHN",
            "identifier": "1047502",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.