Individual provider Active NPI

Jessica Randall, FNP-C

  • Family Nurse Practitioner
  • Waco, TX
National Provider Identifier
1972962942
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP130208 Issued in TX
Practice address
7111 Bosque Blvd Ste 303
Waco, TX 76710-4071
Phone
(254) 307-3997
Fax
(254) 300-9935
NPI assigned
Feb 18, 2016
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP130208 TX Primary

Addresses

Primary practice location

7111 Bosque Blvd Ste 303
Waco, TX 76710-4071

Mailing address

7111 Bosque Blvd Ste 303
Waco, TX 76710-4071
Phone (254) 307-3997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160422000377 TX Practitioner - Nurse Practitioner 2860791092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vesper Medical Care PLLCGroup PAC ID 4880097237, 27 clinicians

Practice addresses (Care Compare)

8416 Old McGregor Rd
Woodway, TX 76712-6499
Phone (254) 307-3997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vesper Medical Care PLLC CurrentSince Mar 1, 2023 Accepting new patients
McLennan County Hospitalist Services PA CurrentSince Sep 7, 2016 Accepting new patients

Locations

6901 Medical Pkwy
Waco, TX 76712
Phone (254) 751-4000

7111 Bosque Blvd
Ste 303
Waco, TX 76710
Phone (254) 307-3997

8416 Old McGregor Rd
Woodway, TX 76712
Phone (254) 307-3997

Organizations & group practices 2

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": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1972962942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 BOSQUE BLVD STE 303",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104071",
            "telephone_number": "254-307-3997",
            "fax_number": "254-300-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 BOSQUE BLVD STE 303",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104071",
            "telephone_number": "254-307-3997",
            "fax_number": "254-300-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JESSICA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-18",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.