Individual provider Active NPI

Randi Jo Ordner, MA, LMFT

  • Marriage & Family Therapist
  • Maple Grove, MN
National Provider Identifier
1417781659
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2497 Issued in MN
Practice address
11280 86TH Ave N
Maple Grove, MN 55369-4510
Phone
(763) 242-6598
NPI assigned
Aug 29, 2024
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 2497 MN Primary

Addresses

Primary practice location

11280 86TH Ave N
Maple Grove, MN 55369-4510

Mailing address

11280 86TH Ave N
Maple Grove, MN 55369-4510
Phone (763) 242-6598

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241007001595 MN Practitioner - Marriage and Family Therapist 7315478955 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2497MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthwise Psychology, PA Multi-Specialty CurrentSince Sep 10, 2024 Accepting new patients
Scott M Yarosh, LLC Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients

Locations

11280 86th Ave N
Maple Grove, MN 55369
Phone (763) 400-7828

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1417781659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11280 86TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694510",
            "telephone_number": "763-242-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11280 86TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694510",
            "telephone_number": "763-242-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORDNER",
        "first_name": "RANDI",
        "middle_name": "JO",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.