Individual provider Active NPI

Randall Wilks, AUD

  • Audiologist
  • Decatur, AL
National Provider Identifier
1982876520
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0872A Issued in AL
Practice address
1218 13TH Ave SE
Decatur, AL 35601-4307
Phone
(256) 355-6200
Fax
(256) 355-6241
NPI assigned
Mar 24, 2008
Last updated
Jan 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0872A AL Primary

Addresses

Primary practice location

1218 13TH Ave SE
Decatur, AL 35601-4307

Mailing address

1218 13TH Ave SE
Decatur, AL 35601-4307
Phone (256) 355-6200

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

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1982876520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 13TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014307",
            "telephone_number": "256-355-6200",
            "fax_number": "256-355-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 13TH AVE SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014307",
            "telephone_number": "256-355-6200",
            "fax_number": "256-355-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "RANDALL",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-24",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AL",
            "license": "0872A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; 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.