DR. KYLE ROBERT RANDALL (NPI# 1154396364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154396364 |
| Entity Type | Individual |
| Full Name | DR. KYLE ROBERT RANDALL |
| Credential | MD |
| Practice Address |
2911 Knapp St Ne Suite A Grand Rapids MI 49525 |
| Practice Telephone | 6164519925 |
| Practice Fax Number | 6163285380 |
| Mailing Telephone | 6164519925 |
| Mailing Fax Number | 6163285380 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2014-11-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 4301061642 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4334872-10 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932533445 | Kyle William Randall | Nurse Practitioner | 622 W Maple St Ste B, Farmington, NM 87401-6589 | 2013-09-03 |
| 1750554218 | Kyle Randall | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2008-04-04 |
| Street Address |
2911 KNAPP ST NE SUITE A |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881691962 | Jerome Daniel Broderick | Physical Therapist | 2911 Knapp St Ne, Suite C, Grand Rapids, MI 49525-4600 | 2005-07-05 |
| 1275762973 | Kara Jo Schipper | Physical Therapist | 2911 Knapp St Ne, Suite C, Grand Rapids, MI 49525-4600 | 2009-07-02 |
| 1871677294 | Achieve Physical Therapy and Sports Rehab, LLC | Physical Therapist | 2911 Knapp St Ne, Suite C, Grand Rapids, MI 49525-4600 | 2006-10-24 |
| 1932174109 | Michigan Orthopaedics and Sports Medicine, PC | Orthopaedic Surgery | 2911 Knapp St Ne, Suite A, Grand Rapids, MI 49525 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053773507 | Charles Trevor Crellin | Orthopaedic Surgery | 221 Michigan St Ne Fl 4, Grand Rapids, MI 49503-2543 | 2016-03-23 |
| 1366799124 | Marci Anne Bartholomew | Orthopaedic Surgery | 221 Michigan St Ne Ste 402, Grand Rapids, MI 49503-2538 | 2012-08-11 |
| 1568723484 | Gable Bert Moffitt | Orthopaedic Surgery | 221 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2543 | 2012-06-07 |
| 1114287893 | Larry W Fitzsimmons | Orthopaedic Surgery | 7660 Pine Park Dr Se, Grand Rapids, MI 49546-9130 | 2012-05-29 |
| 1073809935 | Katherine J Sage | Orthopaedic Surgery | 1195 Wilson Ave Nw Ste 200, Grand Rapids, MI 49534-6405 | 2011-06-20 |
| 1831418151 | Rohan Ashok Habbu | Orthopaedic Surgery | 1422 Dewberry Pl Ne, Apt 16, Grand Rapids, MI 49505-6918 | 2010-05-26 |
| 1750543674 | Mary A Herzog | Orthopaedic Surgery | 300 Lafayette Ave Se # 3400, Grand Rapids, MI 49503-4600 | 2008-07-01 |
| 1184883605 | Melissa Marie Peters | Orthopaedic Surgery | 145 Michigan St Ne Ste 5500, Grand Rapids, MI 49503-2565 | 2008-06-09 |
| 1871782136 | Casey R Bartman Md PC | Orthopaedic Surgery | 751 Kenmoor Ave, Grand Rapids, MI 49546 | 2007-10-23 |
| 1871629857 | Thomas G Schwaderer | Orthopaedic Surgery | 2558 Alger Se, Grand Rapids, MI 49546-5602 | 2007-02-26 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
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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.