NPIMap

Individual provider Active NPI

Randy Heater

  • Addiction (Substance Use Disorder) Counselor
  • Tigard, OR
National Provider Identifier
1306209838
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
15-P-04 Issued in OR
Practice address
10763 SW Greenburg Rd Ste 100
Tigard, OR 97223-5492
Phone
(503) 684-8159
Fax
(503) 598-0934
NPI assigned
Apr 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15-P-04 OR Primary

Addresses

Primary practice location

10763 SW Greenburg Rd Ste 100
Tigard, OR 97223-5492

Mailing address

10763 SW Greenburg Rd Ste 100
Tigard, OR 97223-5492
Phone (503) 684-8159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15-P-04ORMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
CRC Health Oregon, LLC Past Accepting new patients
CRC Health Oregon, LLC Past Accepting new patients

Organizations & group practices 2

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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1306209838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10763 SW GREENBURG RD STE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235492",
            "telephone_number": "503-684-8159",
            "fax_number": "503-598-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10763 SW GREENBURG RD STE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235492",
            "telephone_number": "503-684-8159",
            "fax_number": "503-598-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATER",
        "first_name": "RANDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "15-P-04",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.