Randy A Sansone, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

35 042495 Issued in OH

Practice address

2115 Leiter Rd
Miamisburg, OH 45342-3659

Phone

(937) 384-6850

Fax

(937) 384-6939

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1184615411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423659",
            "telephone_number": "937-384-6850",
            "fax_number": "937-384-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423659",
            "telephone_number": "937-384-6850",
            "fax_number": "937-384-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSONE",
        "first_name": "RANDY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "35 042495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0477550",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth C Sanchez, PA-C
• Junette A Sanders
• Avneek Singh Sandhu, MD
• Shylien Ranae Sandusky, BA
• Scott Sandy, MD
• Camille Sargent, RBT
• Christa Rae Sasser, LPN
• Molly Jane Sautman
• Luka Milan Savic
• Megan Sawyer

• Child & Adolescent Psychiatry Physician in Miamisburg, OH
• Providers in Miamisburg, OH by specialty
• Child & Adolescent Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.