Randi McKissick

Primary specialty

Blood Banking Specialist/TechnologistTaxonomy code 246QB0000X

License

45151-TS-0 Issued in NV

Practice address

5425 Australian Ave
Las Vegas, NV 89142-2702

Phone

(801) 824-3611

NPI assigned

Aug 16, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Randi Mason Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1992250252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 AUSTRALIAN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891422702",
            "telephone_number": "801-824-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 AUSTRALIAN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891422702",
            "telephone_number": "801-824-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKISSICK",
        "first_name": "RANDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QB0000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Blood Banking",
            "state": "NV",
            "license": "45151-TS-0",
            "primary": true
        },
        {
            "code": "246QB0000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Blood Banking",
            "state": "UT",
            "license": "3137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDI",
            "last_name": "MASON",
            "credential": "BB(ASCP)",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley McKinzie
• Kenshia McKinzie
• Tiffany McKinzie
• Tyre McKinzie
• Hadiyah McKissack
• John Mason McKittrick
• James M McKivigan, P.T.
• Jasmine Ariel McKneely
• April McKnight-Paladino
• Barbara McKnight

• Pathology Specialist/Technologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pathology Specialist/Technologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.