NPI Code Detail JSON Logo

1245321835 NPI number — RANDY L ANDREGG O.D.

NPI Number: 1245321835
Health Care Provider/Practitioner: RANDY L ANDREGG O.D.

Information about “1245321835” NPI (RANDY L ANDREGG O.D.) exists in 1245321835 in HTML format HTML  |  1245321835 in plain Text format TXT  |  1245321835 in PDF (Portable Document Format) PDF  |  1245321835 in an XML format XML  formats.

NPI Number : 1245321835 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245321835",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ANDREGG",
    "FirstName": "RANDY",
    "MiddleName": "L",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "O.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "610 AMERICANA BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOISE",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83702-6731",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-344-2020",
    "MailingAddressFaxNumber": "208-344-2371",
    "FirstLinePracticeLocationAddress": "610 AMERICANA BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOISE",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83702-6731",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-344-2020",
    "PracticeLocationAddressFaxNumber": "208-344-2371",
    "EnumerationDate": "09/27/2006",
    "LastUpdateDate": "02/27/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "152W00000X",
        "TaxonomyName": "Optometrist",
        "LicenseNumber": "ODP540",
        "LicenseNumberStateCode": "ID",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.