Dana Marie Randall (NPI# 1013211630, PAC ID# 6507048501) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1013211630 |
| PAC ID by PECOS | 6507048501 |
| Professional Enrollment ID | I20191206000585 |
| Full Name | Dana Marie Randall |
| Organization Legal Name | TAHOE ORTHOPEDICS AND SPORTS MEDICINE, INC. |
| Address |
1139 3rd St South Lake Tahoe CA 96150-3465 |
| Phone Number | 5305435554 |
| Gender | F |
| Graduation Year | 2009 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 9537203351 |
| Number of Group Practice Members | 18 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050352 | BARTON MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1139 3rd St, South Lake Tahoe, CA 96150-3465 | 5305435554 | TAHOE ORTHOPEDICS AND SPORTS MEDICINE, INC. |
| 2170 S Ave, South Lake Tahoe, CA 96150-7026 | 5305435554 | TAHOE ORTHOPEDICS AND SPORTS MEDICINE, INC. |
| 212 Elks Point Rd, Suite 200, Zephyr Cove, NV 89448-8001 | 7755898950 | LAKE TAHOE ORTHOPAEDIC INSTITUTE A WATSON-SWANSON PROFESSIONAL CORP |
| Organization Legal Name | TAHOE ORTHOPEDICS AND SPORTS MEDICINE, INC. |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Damian Xavier Garza | Physician Assistant | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Zachary A Child | Orthopedic Surgery | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Amy M Villaret | Physician Assistant | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Gregory Paul Burkard Jr. | Physical Medicine and Rehabilitation | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Jason Call | Physician Assistant | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Lydia Obannon | Physician Assistant | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Alison C Ganong | Physical Medicine and Rehabilitation | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Daniel Todd Robertson | Hand Surgery | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| William H Cottrell Jr. | Orthopedic Surgery | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Jeffrey A Orr | Orthopedic Surgery | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Street Address |
1139 3RD ST |
| City | SOUTH LAKE TAHOE |
| State | CA |
| Zip | 96150-3465 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Damian Xavier Garza | Physician Assistant | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Zachary A Child | Orthopedic Surgery | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Amy M Villaret | Physician Assistant | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| William R Shepard | General Surgery | Tahoe Carson Valley Medical Group Inc | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Kimberly A Evans | General Surgery | Tahoe Carson Valley Medical Group Inc | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Gregory Paul Burkard Jr. | Physical Medicine and Rehabilitation | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Jason Call | Physician Assistant | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Rituparna Das | Neurology | Tahoe Carson Valley Medical Group Inc | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Lydia Obannon | Physician Assistant | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Alison C Ganong | Physical Medicine and Rehabilitation | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erin-elizabeth Maccarry Davis | Chiropractic | 591 Tahoe Keys Blvd, Suite D3, South Lake Tahoe, CA 96150-3359 | |
| Patricia Ferraro | Podiatry | 2229 Barton Ave, South Lake Tahoe, CA 96150-3411 | |
| Christine C Dobrowolski | Podiatry | Lake Tahoe Podiatry A Professional Podiatric Corporation | 2229 Barton Ave, South Lake Tahoe, CA 96150-3411 |
| Sandra J Taylor | General Surgery | Tahoe Carson Valley Medical Group Inc | 2158 Jean Ave, South Lake Tahoe, CA 96150-3412 |
| Amy P Smith | Nurse Practitioner | Tahoe Carson Valley Medical Group Inc | 1067 4th St, South Lake Tahoe, CA 96150-3459 |
| Gregory W Bergner | Family Medicine | Tahoe Carson Valley Medical Group Inc | 1067 4th St, South Lake Tahoe, CA 96150-3459 |
| Daniel Todd Robertson | Hand Surgery | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| William H Cottrell Jr. | Orthopedic Surgery | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Jeffrey A Orr | Orthopedic Surgery | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Steven I Pancio Ii | Orthopedic Surgery | Tahoe Orthopedics and Sports Medicine, Inc. | 1139 3rd St, South Lake Tahoe, CA 96150-3465 |
| Find all physicians in zip 96150 | |||
| City | SOUTH LAKE TAHOE |
| Zip Code | 96150 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SOUTH LAKE TAHOE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Dana Marie Randall.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.