Active NPI
Randy Bohon
- Mental Health Counselor
- Riverview, FL
National Provider Identifier
1447918503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH23444
- Practice address
- 11423 Sunburst Marble Rd
Riverview, FL 33579-2106 - Phone
- (813) 906-9552
- Fax
- (843) 808-2254
- NPI assigned
- Dec 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMH21904 | FL | |
| Mental Health Counselor | 101YM0800X | MH23444 | FL | Primary |
Addresses
Primary practice location
11423 Sunburst Marble Rd
Riverview, FL 33579-2106
Mailing address
PO Box 5571
Sun City Center, FL 33571-5571
Phone (813) 906-9552
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 |
|---|---|---|---|
| IMH21904 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1447918503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5571",
"city": "SUN CITY CENTER",
"state": "FL",
"postal_code": "335715571",
"telephone_number": "813-906-9552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11423 SUNBURST MARBLE RD",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335792106",
"telephone_number": "813-906-9552",
"fax_number": "843-808-2254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHON",
"first_name": "RANDY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-06",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH21904",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH23444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.