NPIMap

Individual provider Active NPI

Dustin Charles Randall, CNP

  • Family Nurse Practitioner
  • Freeman, SD
National Provider Identifier
1982967451
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP000712 Issued in SD
Practice address
804 S. Walnut Street
Freeman, SD 57029
Phone
(605) 925-4219
Fax
(605) 925-4220
NPI assigned
Jun 20, 2012
Last updated
Jun 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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 CP000712 SD Primary

Addresses

Primary practice location

804 S. Walnut Street
Freeman, SD 57029

Mailing address

804 S Walnut St
Freeman, SD 57029-2033
Phone (605) 925-4219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120813000140 SD Practitioner - Nurse Practitioner 2466608138 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeman Regional Health ServicesGroup PAC ID 7315908324, shared by 5 NPIs, 6 clinicians

Practice addresses (Care Compare)

804 S Walnut St
Freeman, SD 57029-2033
Phone (605) 925-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP000712SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Freeman Regional Health Services CurrentSince Oct 1, 2025 Accepting new patients
Avera Queen of Peace CurrentSince Aug 1, 2015 Accepting new patients
Avera Queen of Peace Current Accepting new patients
Platte Community Memorial Hospital Inc Current Accepting new patients
Freeman Regional Health Services CurrentSince Dec 25, 2023 Accepting new patients
Platte Community Memorial Hospital Inc. CurrentSince Aug 1, 2015 Accepting new patients
Freeman Regional Health Services CurrentSince Dec 25, 2023 Accepting new patients
Rural Medical Clinics Current Accepting new patients
Platte Community Memorial Hospital, Inc. PastSince Aug 1, 2021 Accepting new patients

Locations

804 S Walnut St
Freeman, SD 57029
Phone (605) 925-4000

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

601 E 7th St
Platte, SD 57369
Phone (605) 337-2633

601 E 7th St
Ste 3
Platte, SD 57369
Phone (605) 337-2633

306 S Johnston St
White Lake, SD 57383
Phone (605) 337-1529

Interoperability endpoints

  • Direct secure messaging: dustin.randall@avera.sdhealthlink.net

Organizations & group practices 10

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.

Hospital & facility affiliations 30

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1982967451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 S WALNUT ST",
            "city": "FREEMAN",
            "state": "SD",
            "postal_code": "570292033",
            "telephone_number": "605-925-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 S. WALNUT STREET",
            "city": "FREEMAN",
            "state": "SD",
            "postal_code": "57029",
            "telephone_number": "605-925-4219",
            "fax_number": "605-925-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "DUSTIN",
        "middle_name": "CHARLES",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeman, SD

Sources for this page

Verify at the official NPI Registry.