Active NPI
Randall B. Wenker, PSY.D.
- Clinical Psychologist
- Chillicothe, OH
National Provider Identifier
1356444343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5655
- Practice address
- 17273 State Route 104
Mental Health Care Line 116
Chillicothe, OH 45601-0999 - Phone
- (800) 358-8262
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5655 | OH | Primary |
Addresses
Primary practice location
17273 State Route 104
Mental Health Care Line 116
Chillicothe, OH 45601-0999
Mailing address
17273 State Route 104
Mental Health Care Line 116
Chillicothe, OH 45601-0999
Phone (800) 358-8262
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5655 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356444343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"address_2": "MENTAL HEALTH CARE LINE 116",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456010999",
"telephone_number": "800-358-8262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"address_2": "MENTAL HEALTH CARE LINE 116",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456010999",
"telephone_number": "800-358-8262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENKER",
"first_name": "RANDALL",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "5655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chillicothe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.