TYLER WILLIAM RANDALL (NPI# 1780241794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780241794 |
| Entity Type | Individual |
| Full Name | TYLER WILLIAM RANDALL |
| Practice Address |
1338 Phay Ave Canon City CO 81212-2311 |
| Mailing Address |
Po Box 911057 Denver CO 80291-1057 |
| Practice Telephone | 7192852000 |
| Mailing Telephone | 8009530104 |
| Mailing Fax Number | 3037656640 |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2019-08-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN.0994692-NP | CO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245757533 | Tyler Lincoln Randall | Physical Therapist | 170 Inner Loop Road, Fort Irwin, CA 92310 | 2017-08-28 |
| 1518319318 | Tyler J Randall | Emergency Medicine | 111 Dallas St, San Antonio, TX 78205 | 2016-07-06 |
| Street Address |
1338 PHAY AVE |
| City | CANON CITY |
| State | CO |
| Zip Code | 81212-2311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669462404 | Keith P Minihane | Orthopaedic Surgery | 1338 Phay Ave, Canon City, CO 81212-2302 | 2005-10-24 |
| 1699376764 | Pueblo Radiological Group, P.C. | Radiology | 1338 Phay Ave, Canon City, CO 81212-2311 | 2020-11-05 |
| 1275133506 | Sheridan Childrens Healthcare Services of Colorado PC | Pediatrics | 1338 Phay Ave, Canon City, CO 81212-2311 | 2020-10-27 |
| 1689272585 | Catholic Health Initiatives Colorado | Orthopaedic Surgery | 1338 Phay Ave, Bldg D Ortho, Canon City, CO 81212-2326 | 2020-10-13 |
| 1124634902 | Catholic Health Initiatives Colorado | Obstetrics & Gynecology | 1338 Phay Ave, Bldg D Ob, Canon City, CO 81212-2326 | 2020-09-17 |
| 1073124954 | Catholic Health Initiatives Colorado | Surgery | 1338 Phay Ave, Bldg D Gs, Canon City, CO 81212-2311 | 2020-08-13 |
| 1467061036 | Catholic Health Initiatives Colorado | Internal Medicine | 1338 Phay Ave, Canon City, CO 81212-2311 | 2020-07-29 |
| 1659907046 | Usacs of Colorado Inc | Emergency Medicine | 1338 Phay Ave, Canon City, CO 81212-2311 | 2020-03-17 |
| 1790278950 | Rachel Ruth Maxwell | Physical Therapist | 1338 Phay Ave, Canon City, CO 81212-2311 | 2018-06-12 |
| 1689189227 | Miriam Loomis | Dietitian, Registered | 1338 Phay Ave, Canon City, CO 81212-2311 | 2017-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212393 | Buck Jack LLC | Physical Therapist | Mountain View Core Knowledge School 890 Field Ave, Cannon City, CO 81212 | 2020-10-09 |
| 1942841374 | Glorious Works Neurotherapy | Community/Behavioral Health | 115 N 7th Street, Canon City, CO 81212 | 2019-10-07 |
| 1376046292 | Lonnie Mccarron | Social Worker | 600 Evans Rd, Fremont Correctional Facility, Canon City, CO 81212 | 2018-03-16 |
| 1487156964 | Patrick Neil Cox | Case Manager/Care Coordinator | 3239 Independence Road, Canon City, CO 81212 | 2018-03-01 |
| 1831559806 | Justin Ensinger | Counselor | 700 Four Mile Parkway, Canon City, CO 81212 | 2016-03-03 |
| 1710365713 | Amber Conover | Health Educator | 105 N 10th Street, Canon City, CO 81212 | 2015-05-11 |
| 1902073448 | Richard R Williams | Counselor | 612 Field Ave, Canon City, CO 81212 | 2008-05-14 |
| 1861662249 | Huh Inc | Hearing Instrument Specialist | 121 Justice Center Rd Ste D, Canon City, CO 81212 | 2008-03-03 |
| 1013113828 | Deborah Eileen Shock | Nurse Practitioner | 275 W Hwy 50, Canon City, CO 81212 | 2007-06-27 |
| 1245433564 | Lindsey Elizabeth Fish | Internal Medicine | 275 West Hwy 50, Colorado Territorial Correctional Facility, Canon City, CO 81212 | 2007-06-06 |
| Find all providers in zip 81212 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679641369 | Kathleen Boyd | Nurse Practitioner | 57500 E Us Highway 50, Canon City, CO 81212-9363 | 2006-12-01 |
| 1528134061 | Janice Chamelin Eades | Nurse Practitioner | 275 West Highway 50, Canon City, CO 81212 | 2006-11-27 |
| 1295369908 | Jessica Blu Erickson | Nurse Practitioner | 715 S 9th St, Canon City, CO 81212-4911 | 2020-03-03 |
| 1073145181 | Melissa Rogers | Nurse Practitioner | 600 Evans Rd, Canon City, CO 81212 | 2020-02-06 |
| 1326507948 | Steffanie Lynn Fabian | Nurse Practitioner | 730 Macon Ave, Canon City, CO 81212-3314 | 2019-03-13 |
| 1396209680 | Katherine Lee Wolff | Nurse Practitioner | 57500 E Hwy 50, Canon City, CO 81212-9363 | 2019-01-30 |
| 1396221362 | Alicia Kielas | Nurse Practitioner | 715 S 9th St, Canon City, CO 81212-4911 | 2018-07-12 |
| 1629588504 | Lindsey Gavioli Fox | Nurse Practitioner | 1338 Phay Ave, Canon City, CO 81212-2311 | 2017-10-05 |
| 1396275871 | Jennifer Leigh Simpson | Nurse Practitioner | 715 S 9th St, Canon City, CO 81212-4911 | 2017-06-15 |
| 1841745601 | Maranda Ray | Nurse Practitioner | 3225 Independence Rd, Canon City, CO 81212-9380 | 2016-08-23 |
| Find all providers in CANON CITY | ||||
| City | CANON CITY |
| Zip Code | 81212 |
Please comment or provide details below to improve the information on TYLER WILLIAM 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.