Michael John Randall, 3747P1801X

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

0441283 Issued in OH

Practice address

1109 Mead Rd
Bellbrook, OH 45305-8747

Phone

(937) 973-9199

NPI assigned

Aug 30, 2017

Last updated

May 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Pike County Recovery Council Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waverly, OH
  • NPI 1760742993
  NPD (past)

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1336667336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 1/2 W 5TH ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456013034",
            "telephone_number": "937-397-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 MEAD RD",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453058747",
            "telephone_number": "937-973-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "3747P1801X",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-30",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCII.161340",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "OH",
            "license": "0441283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crista Osterhage, AGACNP
• Karen Lee Ostrander, BA, LSW, MA, PC
• Ann Marie Piselli
• Pristine Senior Living of Bellbrook, LLC
• Breana Ramus, LISW-S
• Rar Optometry Inc (Bellbrook Vision Center)
• Hannah Ruth Reckman
• Lauren Redfern
• George W. Reed, O.D.
• Joshua A Ross, D.C.

• Personal Care Attendant in Bellbrook, OH
• Providers in Bellbrook, OH by specialty
• Personal Care Attendant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.