TYLER WILLIAM RANDALL NPI 1780241794

NPI Information

  • NPI: 1780241794
  • Provider Name: TYLER WILLIAM RANDALL
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1338 PHAY AVE
    CANON CITY, CO
    ZIP 81212
  • Phone: (719) 285-2000

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NPI Details

Tyler William Randall is a family nurse practitioner in Canon City, CO with 6 years of experience. Tyler William Randall NPI is 1780241794. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1338 PHAY AVE
CANON CITY, CO
ZIP 81212-311
Phone: (719) 285-2000

The NPI 1780241794 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/24/2019 and was last updated on 6/19/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerAP61177225WASHINGTONNo
2363LF0000XNurse PractitionerFamilyAP61177225WASHINGTONNo
3363LF0000XNurse PractitionerFamilyAPN.0994692-NPCOLORADOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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