MR. THOMAS RANDALL REARDON (NPI# 1174817423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174817423 |
| Entity Type | Individual |
| Full Name | MR. THOMAS RANDALL REARDON |
| Credential | RN, MS, NP(C) |
| Practice Address |
Highway 160 Mile Post 394.3 Kayenta AZ 86033-0368 |
| Mailing Address |
Po Box 368 Kayenta AZ 86033-0368 |
| Practice Telephone | 9286974120 |
| Practice Fax Number | 9286974083 |
| Mailing Telephone | 9286974000 |
| Mailing Fax Number | 9286974145 |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2018-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN089784 | GA | Nursing Service Providers |
| N | 163WG0000X |
Registered Nurse Specialization: General Practice |
RN207769 | AZ | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP10252 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN089784 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730164443 | Thomas Francis Reardon | Internal Medicine | 771 Gabriel Ct, Kirkwood, MO 63122-3612 | 2005-12-14 |
| 1467828756 | Thomas Reardon | Pharmacist | 4411 Howley St, Pittsburgh, PA 15224-1509 | 2015-08-20 |
| 1336478445 | Thomas C Reardon | Nurse Practitioner | 1836 South Ave, La Crosse, WI 54601-5429 | 2009-12-18 |
| 1376722587 | Thomas G Reardon | Chiropractor | 1717 Ne 44th St, Suite G, Renton, WA 98056-9001 | 2007-10-24 |
| 1073527511 | Thomas Edward Reardon | Physician Assistant | 1 Ingalls Dr, Harvey, IL 60426-3558 | 2006-07-28 |
| 1538168711 | Thomas M Reardon | Surgery | 2750 Clay Edwards Dr, Suite 312, North Kansas City, MO 64116-3237 | 2005-07-19 |
| Street Address |
HIGHWAY 160 MILE POST 394.3 |
| City | KAYENTA |
| State | AZ |
| Zip Code | 86033-0368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048306 | Pauletta A Butterfly | Social Worker | Hwy. 160 Mp 394.3, Kayenta, AZ 86033 | 2019-11-20 |
| 1871143255 | Andrea Dawn Begay | Nurse's Aide | Us Hwy 160 M.p. 394.3, Kayenta, AZ 86033 | 2019-09-17 |
| 1083264451 | Mavis Ann Bahe | Nurse's Aide | Kayenta Health Center, Us Hwy 160, Mp 394.3, Kayenta, AZ 86033 | 2019-09-17 |
| 1609420165 | Emily Ingram Nimon | Registered Nurse | Kayenta Health Center Hwy 160 M.p. 394.3, Kayenta, AZ 86033 | 2019-08-01 |
| 1700439577 | Sherri A Verdon | Registered Nurse | Hwy 160 M.p 394.3, Kayenta, AZ 86033 | 2019-07-22 |
| 1447712104 | Cynthia Kaye Robbins | Registered Nurse | Us Highway 160 Mile Post 394.3, Kayenta, AZ 86033 | 2019-04-02 |
| 1871051052 | Brian Jason Miller | Registered Nurse | Hwy 160, Mile Post 394.3, Kayenta, AZ 86033 | 2019-03-07 |
| 1265915615 | Marissa Brooke Wall | Optometrist | 394.3 Us-160, Kayenta, AZ 86033 | 2018-09-12 |
| 1467952762 | Michael Ruddy | Pharmacist | Hwy 160 1/2 Mile South of Mile Post 394.3, Kayenta, AZ 86033 | 2018-02-14 |
| 1922516319 | Xavier Kelton Nelson | Spec/Tech, Pathology | Highway 160 Mp 394.3, Kayenta Health Center, Kayenta, AZ 86033 | 2018-01-19 |
| Find all providers in zip 86033 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053675934 | Lorraine D Kelwood | Nurse Practitioner | Highway 163 Building Ka 2010, Kayenta Health Center, Kayenta, AZ 86033 | 2012-06-26 |
| 1376573626 | Connie Jo Larkin | Nurse Practitioner | Hwy 160/163 Building Ka2010, Dhhs Naihs Phs Kayenta Health Center, Kayenta, AZ 86033-0368 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760921 | Valerie Pong | Nurse Practitioner | 530 Karen Way, Bullhead City, AZ 86442-6177 | 2020-11-03 |
| 1407456783 | Brenna Michelle Clements | Nurse Practitioner | 3226 W Donatello Dr, Phoenix, AZ 85086-2200 | 2020-10-27 |
| 1902406499 | Kimberly Brown | Nurse Practitioner | 4315 N Adams St, Kingman, AZ 86409-2610 | 2020-10-26 |
| 1669071361 | Harmony Clinic and Medspa | Nurse Practitioner | 670 E 32nd St Ste 8, Yuma, AZ 85365-3576 | 2020-10-22 |
| 1528667615 | Elena Eloriaga | Nurse Practitioner | 1925 S Coronado Rd Apt 2133, Gilbert, AZ 85295-2219 | 2020-10-20 |
| 1942809165 | Barbara Powers | Nurse Practitioner | 9251 E Snyder Rd, Tucson, AZ 85749-9443 | 2020-10-19 |
| 1861091175 | Guiding Light Holistic Healthcare | Nurse Practitioner | 9758 S La Rosa Dr, Tempe, AZ 85284-5004 | 2020-10-19 |
| 1598364838 | Ryan Nelson Sutton | Nurse Practitioner | 3719 E Loma Vista St, Gilbert, AZ 85295-4675 | 2020-10-19 |
| 1942808431 | Vera Adell Dujmic | Nurse Practitioner | 10959 E Actinidia St, Tucson, AZ 85747-8862 | 2020-10-15 |
| 1376141184 | Laura E Ahumada | Nurse Practitioner | 3417 N Sand Creek Ct, Tucson, AZ 85745-7126 | 2020-10-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.