Active NPI
Raegan Marie Radenheimer, PSYD
- Clinical Psychologist
- Miami, FL
National Provider Identifier
1457524126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY7673
- Practice address
- 1201 NW 16TH St
116
Miami, FL 33125-1624 - Phone
- (305) 324-4455
- NPI assigned
- Apr 2, 2008
- Sex
- Female
- 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 | PY7673 | FL | Primary |
Addresses
Primary practice location
1201 NW 16TH St
116
Miami, FL 33125-1624
Mailing address
359 Meridian Ave
A201
Miami Beach, FL 33139-8702
Phone (305) 324-4455
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY7673 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207094400000",
"number": "1457524126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "359 MERIDIAN AVE",
"address_2": "A201",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331398702",
"telephone_number": "305-324-4455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 NW 16TH ST",
"address_2": "116",
"city": "MIAMI",
"state": "FL",
"postal_code": "331251624",
"telephone_number": "305-324-4455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADENHEIMER",
"first_name": "RAEGAN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-02",
"last_updated": "2008-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY7673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.