Individual provider Active NPI

Randall R Hieber, O.D.

  • Optometrist
  • Galion, OH
National Provider Identifier
1114922218
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3414/T925 Issued in OH
Practice address
337 Harding Way W
Galion, OH 44833-1725
Phone
(419) 468-3355
Fax
(419) 468-7475
NPI assigned
Jun 15, 2005
Reactivated
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3414/T925 OH Primary

Addresses

Primary practice location

337 Harding Way W
Galion, OH 44833-1725

Mailing address

337 Harding Way W
Galion, OH 44833-1725
Phone (419) 468-3355

Other identifiers 1

IdentifierTypeStateIssuer
0411263MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000167 OH Practitioner - Optometry 5597870063 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3414/T925OHMDOptometrist

Interoperability endpoints

  • Direct secure messaging: randall.hieber.p1@direct.centerstreetclinic.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1114922218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 HARDING WAY W",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448331725",
            "telephone_number": "419-468-3355",
            "fax_number": "419-468-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 HARDING WAY W",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448331725",
            "telephone_number": "419-468-3355",
            "fax_number": "419-468-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIEBER",
        "first_name": "RANDALL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2010-06-29",
        "deactivation_date": "2006-03-18",
        "reactivation_date": "2006-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3414/T925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0411263",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galion, OH

Sources for this page

Verify at the official NPI Registry.