Individual provider Active NPI

Chelsea Randall, DMD

  • Dentist
  • Roanoke, VA
National Provider Identifier
1982086609
Registry record updated Jun 19, 2015
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
442000234 Issued in VA
Practice address
2523 Rosalind Ave SW
Roanoke, VA 24014-2370
Phone
(704) 698-6305
NPI assigned
Jun 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 442000234 VA Primary

Addresses

Primary practice location

2523 Rosalind Ave SW
Roanoke, VA 24014-2370

Mailing address

2523 Rosalind Ave SW
Apt #3
Roanoke, VA 24014-2370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150909000655 VA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9335455203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
442000234VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1982086609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 ROSALIND AVE SW",
            "address_2": "APT #3",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 ROSALIND AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142370",
            "telephone_number": "704-698-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "CHELSEA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "442000234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.