John Wilfred Randall, OD, MPH

Primary specialty

OptometristTaxonomy code 152W00000X

License

1610AT Issued in OR

Practice address

2043 College Way
Pacific University College of Optometry
Forest Grove, OR 97116-1756

Phone

(503) 352-2020

Fax

(503) 352-2929

NPI assigned

Nov 2, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kayenta Alternative Rural HospitalGroup PAC ID 3678558129, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kayenta Alternative Rural Hospital Hospital, Kayenta, AZ, CCN 030195

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kayenta Alternative Rural Hospital

  • General Acute Care Hospital
  • Kayenta, AZ
  • NPI 1174692529

  TX

  Medicare reassignment Care Compare group NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  dba Northern Navajo Medical Center

  • General Acute Care Hospital
  • Shiprock, NM
  • NPI 1780639971

  TX

  Medicare reassignment NPD
• US Health Dept of Health & Human Services

  • Rural Health Clinic/Center
  • Poplar, MT
  • NPI 1972694602

  TX

  Medicare reassignment NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teec Nos Pos, AZ
  • NPI 1477615789
  NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  dba Dzilth-Na-O-Dith-Hle Health Center

  • General Acute Care Hospital
  • Bloomfield, NM
  • NPI 1760427587
  NPD
• Kayenta Alternative Rural Hospital

  dba Inscription House Health Center

  • General Acute Care Hospital
  • Tonalea, AZ
  • NPI 1740359108
  NPD
• DHHS IHS Phoenix Area

  dba Hopi Health Care Center

  • Critical Access Hospital
  • Polacca, AZ
  • NPI 1356628028

  Optometrist

  NPD (past)
• DHHS PHS Naihs Fort Defiance Hospital

  dba PHS Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1700962131
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982695524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 EILER LN",
            "city": "ZILLAH",
            "state": "WA",
            "postal_code": "989539731",
            "telephone_number": "509-865-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 COLLEGE WAY",
            "address_2": "PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161756",
            "telephone_number": "503-352-2020",
            "fax_number": "503-352-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "JOHN",
        "middle_name": "WILFRED",
        "name_prefix": "Dr.",
        "credential": "OD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1610AT",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troy Pound, MA, NCC, LPC, LMHC
• Elizabeth Anna Powers
• Prolanguage Interpreters
• Sara Melissa Pullum-Pinon, LMSW
• R L Goff Enterprises, Inc (Forest Grove Pharmacy LLC)
• Raven Song Counseling
• Lee Ann Remington, O.D.
• Restore Massage Therapy, Inc
• Roger Reynolds, D.O.
• Richardson Eyecare PC

• Optometrist in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.