GARY R RANDALL (NPI# 1447647961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447647961 |
| Entity Type | Individual |
| Full Name | GARY R RANDALL |
| Practice Address |
762 Falls Ave Twin Falls ID 83301-3316 |
| Mailing Address |
1607 Dana St Twin Falls ID 83301-5662 |
| Practice Telephone | 2087344200 |
| Practice Fax Number | 2087341404 |
| Mailing Telephone | 2089859466 |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
11540037 | ID | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | LSW-26213 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104165323 | Gary Cagan Randall | Chiropractor | 100 W Southlake Blvd Ste 410, Southlake, TX 76092-6166 | 2013-02-07 |
| 1962818740 | Gary Randall | Social Worker | 209 E Lewis St, Pocatello, ID 83201-6465 | 2014-07-01 |
| 1194733733 | Gary Milton Randall | Family Medicine | 100 W Southlake Blvd, Ste 410, Southlake, TX 76092-6166 | 2006-08-03 |
| Street Address |
762 FALLS AVE |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-3316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407020357 | Jesus Ortega | Counselor | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2008-04-22 |
| 1528504206 | Sarah Deaun Walling-gifford | Social Worker | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2017-01-18 |
| 1831512284 | Mary Ellen San Roman | Counselor | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2014-01-21 |
| 1629356407 | Kathy Blamires | Counselor | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2011-07-28 |
| 1629373568 | Dalana Justesen-baxter | Counselor | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2011-01-25 |
| 1316261274 | Dorothy Hamilton | Counselor | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2010-03-22 |
| 1861667842 | Lejla Becirovic | Social Worker | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2008-04-29 |
| 1184899890 | Dawn Mcarthur | Counselor | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2008-04-23 |
| 1962676866 | Deborah Ann Thomas | Counselor | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2008-04-22 |
| 1356515274 | Margaret Mary Traudt | Counselor | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2008-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073060414 | Lorene Hartje-mahan | Counselor | 219 Gooding St N, Twin Falls, ID 83301-6178 | 2016-09-01 |
| 1518219351 | Kimberly Jean Woodmansee-dopson | Counselor | 808 Eastland Dr, Suite D, Twin Falls, ID 83301-6813 | 2012-10-03 |
| 1861727869 | Mari Christina Nelson | Counselor | 488 Blue Lakes Blvd. North, Suite #108, Twin Falls, ID 83301 | 2009-10-08 |
| 1407020357 | Jesus Ortega | Counselor | 762 Falls Ave, Twin Falls, ID 83301-3316 | 2008-04-22 |
| 1821273251 | Jaime Rae Goffin | Counselor | 220 4th Avenue East, Twin Falls, ID 83301-4008 | 2008-01-03 |
| 1891994307 | Wade M Falconburg | Counselor | 202 2nd Ave N, Suite B, Twin Falls, ID 83301-6158 | 2007-07-13 |
| 1376183541 | Monica Marie Shaff | Counselor | 1102 Eastglen Way, Twin Falls, ID 83301-7671 | 2020-01-15 |
| 1790201010 | Joseph Gallagher | Counselor | 420 Main Ave S, Twin Falls, ID 83301-6424 | 2017-08-17 |
| 1689121956 | Ken Bohr | Counselor | 219 Gooding St N, Twin Falls, ID 83301-6178 | 2016-09-05 |
| 1417404757 | Jodi Gruendler | Counselor | 219 Gooding St N, Twin Falls, ID 83301-6178 | 2016-09-02 |
| Find all providers in TWIN FALLS | ||||
| City | TWIN FALLS |
| Zip Code | 83301 |
Please comment or provide details below to improve the information on GARY R RANDALL.
| 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.