Active NPI
Joel David Randall, PA-C
- Medical Physician Assistant
- Spokane, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10005090
- Practice address
- 104 W 5TH Ave
Suite 400W
Spokane, WA 99204-4880 - Phone
- (509) 353-3960
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10005090 | WA | Primary |
| Physician Assistant | 363A00000X | PA10005090 | WA |
Addresses
Primary practice location
104 W 5TH Ave
Suite 400W
Spokane, WA 99204-4880
Mailing address
122 W 7TH Ave Ste 110
Spokane, WA 99204-2301
Phone (509) 462-6485
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 474-3131
5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 482-0111
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10005090 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Sound Inpatient Physicians PLLC | Current | Accepting new patients | |
| South Sound Inpatient Physicians PLLC | Current | Accepting new patients | |
| Providence Health & Services Washington | Current | Accepting new patients | |
| Spokane Critical Care Associates, PS | Past | Accepting new patients |
Locations
1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701
407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000
101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Critical Care Medicine (Internal Medicine) Physician
- Spokane, WA
- NPI 1528582699
-
dba Providence Medical Group
- Pulmonary Disease Physician
- Spokane, WA
- NPI 1194099390
-
dba Sound Inpatient Physicians
- Internal Medicine Physician
- Vancouver, WA
- NPI 1023285756
-
dba Sound Inpatient Physicians
- Internal Medicine Physician
- Bremerton, WA
- NPI 1831366566
-
dba Sound Inpatient Physicians
- Internal Medicine Physician
- Hillsboro, OR
- NPI 1508023789
-
dba Spokane Respiratory Consultants
- Specialist
- Spokane Valley, WA
- NPI 1083668008
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Prov Scred Hrt Med Ctr & Chlds Hos
- General Acute Care Hospital
- Spokane, WA
- NPI 1144471715
-
dba Providence Holy Family Hospital
- General Acute Care Hospital
- Spokane, WA
- NPI 1225289895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444089600000",
"number": "1982793568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 W 7TH AVE STE 110",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042301",
"telephone_number": "509-462-6485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 W 5TH AVE",
"address_2": "SUITE 400W",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992044880",
"telephone_number": "509-353-3960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "JOEL",
"middle_name": "DAVID",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2015-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10005090",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10005090",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.