RANDALL W CLENDENIN (NPI# 1417009614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417009614 |
| Entity Type | Individual |
| Full Name | RANDALL W CLENDENIN |
| Credential | CO, C-PED |
| Practice Address |
2301 N Church St Greensboro NC 27405-4309 |
| Practice Telephone | 3363339081 |
| Practice Fax Number | 3363339083 |
| Mailing Telephone | 3363339081 |
| Mailing Fax Number | 3363339083 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7795035 | 05 |
| Street Address |
2301 N CHURCH ST |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27405-4309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992781587 | Bio-tech Prosthetics and Orthotics, Inc | Prosthetic/Orthotic Supplier | 2301 N Church St, Greensboro, NC 27405-4309 | 2005-12-16 |
| 1902268956 | John R Crutchfield | Orthotist | 2301 N Church St, Greensboro, NC 27405-4309 | 2016-03-28 |
| 1922150127 | Michael R Neal | Specialist | 2301 N Church St, Greensboro, NC 27405-4309 | 2007-01-17 |
| 1932251147 | Larry D Powers | Specialist | 2301 N Church St, Greensboro, NC 27405-4309 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477038727 | Miya Jackson | Behavior Technician | 2308 Golden Gate Dr, Apt G, Greensboro, NC 27405 | 2018-10-02 |
| 1821576299 | Woodrow Eric Bradley | Day Training/Habilitation Specialist | 1403 Woocbriar Ave, Greensboro, NC 27405 | 2018-07-30 |
| 1922593094 | Constance Foushee | Nurse Practitioner | 1100 E. Wendover, Greensboro, NC 27405 | 2018-06-29 |
| 1760972434 | Ayana Linette Holland | Home Health Aide | 1417 Old Hickory Dr, Greensboro, NC 27405 | 2018-05-17 |
| 1790294700 | G. Antoine Gray | Specialist | 2100 Phillips Avenue, Suite B, Greensboro, NC 27405 | 2017-09-21 |
| 1306375910 | Wendy Carisa Boger | Registered Nurse | 1100 East Wendover Avenue, Greensboro, NC 27405 | 2017-06-07 |
| 1659827715 | Changing Paths Counseling Center Pllc | Community/Behavioral Health | 1600 E Wendoer Ave., Suite C, Greensboro, NC 27405 | 2016-08-29 |
| 1295187896 | Amanda Kirby Counseling, PC | Counselor | 1175 Revolution Mill Drive, Suite 29-2, Greensboro, NC 27405 | 2016-07-07 |
| 1780049429 | Pta | Residential Treatment Facility, Physical Disabilities | 1900 Sheldon Road, Greensboro, NC 27405 | 2015-12-23 |
| 1841655644 | Amaya Nicole Hardy | Counselor | 1600r E Wendover Ave Ste R, Greensboro, NC 27405 | 2015-12-21 |
| Find all providers in zip 27405 | ||||
| Taxonomy Code | 1744P3200X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| Specialization | Prosthetics Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255983664 | Monica Harris | Specialist | 3714 Pineway Dr, Greensboro, NC 27405-2822 | 2019-07-15 |
| 1265907000 | Jessica Marjorie Phifer | Specialist | 3909 Edgewood Terrace Dr, Greensboro, NC 27406-2740 | 2018-10-08 |
| 1790294700 | G. Antoine Gray | Specialist | 2100 Phillips Avenue, Suite B, Greensboro, NC 27405 | 2017-09-21 |
| 1669903589 | Reba Siler Kennedy | Specialist | 1325 South Eugene Street, Suite 102, Greensboro, NC 27406 | 2017-03-22 |
| 1225406143 | Latonya Evans | Specialist | 808 Merritt Dr, Greensboro, NC 27407-2237 | 2015-09-09 |
| 1124363163 | Zolee Viel Davis-robinson | Specialist | 1505 Bearhollow Rd, Suite Lower, Greensboro, NC 27410-3613 | 2012-12-03 |
| 1821097312 | Ramona Hertzell | Specialist | 500 State St., Unit A, Greensboro, NC 27405-5659 | 2005-07-18 |
| 1679765531 | Jeff Smith | Specialist | 2800 Saint Leo St, Greensboro, NC 27405-3382 | 2007-08-15 |
| 1598964942 | Nelson Christiano Roura II | Specialist | 2800 Saint Leo St, Greensboro, NC 27405-3382 | 2007-07-16 |
| 1922150127 | Michael R Neal | Specialist | 2301 N Church St, Greensboro, NC 27405-4309 | 2007-01-17 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27405 |
Please comment or provide details below to improve the information on RANDALL W CLENDENIN.
| 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.