Provider Demographics
NPI:1215316070
Name:YONTZ, RANDI L (AUD)
Entity type:Individual
Prefix:DR
First Name:RANDI
Middle Name:L
Last Name:YONTZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:RANDI
Other - Middle Name:L
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1994 GALLATIN PIKE N STE 200
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2024
Mailing Address - Country:US
Mailing Address - Phone:615-851-9005
Mailing Address - Fax:615-851-9007
Practice Address - Street 1:1994 GALLATIN PIKE N STE 200
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2024
Practice Address - Country:US
Practice Address - Phone:615-851-9005
Practice Address - Fax:615-851-9007
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237600000X
TN0000001755231H00000X
WALD 60526588231H00000X
MN9369231H00000X
TN237600000X, 237700000X
TN1755231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I648040OtherMEDICARE