Randall John Ambrosius, MSW CADCIII LCSW

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1834 Issued in WI

Practice address

2611 12TH St S
Mental Health Aoda Clinic
Wisconsin Rapids, WI 54494

Phone

(715) 421-8849

Fax

(715) 421-2266

NPI assigned

Nov 28, 2006

Last updated

Jan 29, 2008By 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

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Aspirus Stevens Point Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Stevens Point, WI
  • NPI 1538112230
  Medicare reassignment NPD
• La Clinica de Los Campesinos, Inc

  dba Noble Community Clinics

  • Federally Qualified Health Center (FQHC)
  • Stevens Point, WI
  • NPI 1790786929
  Medicare reassignment
• Aspirus Stevens Point Hospital & Clinics, Inc.

  dba Aspirus Behavioral Health Clinic - Stevens Point - Prentice St

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1679706022
  NPD
• Interim Hospice & Palliative Care

  dba Interim Hospice and Palliative Care

  • Community Based Hospice Care Agency
  • Wausau, WI
  • NPI 1215229604
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1487720769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 12TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "54494",
            "telephone_number": "715-421-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 12TH ST S",
            "address_2": "MENTAL HEALTH AODA CLINIC",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "54494",
            "telephone_number": "715-421-8849",
            "fax_number": "715-421-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSIUS",
        "first_name": "RANDALL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MSW CADCIII LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1834",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "4186123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Scott Akey, D.D.S.
• Ma Lourdes Mauricio Akyurt, P.T.
• Anthony Hugo Alde, LMT
• Grace Alnes, PTA
• Alpine Home Medical LLC
• Megan Amundson, DPT
• Bethany Lee Anderson
• Donna J Anderson, PT
• Jaimie Jo Anderson
• Andrea M Bertotto, D.D.S., S.C.

• Addiction (Substance Use Disorder) Counselor in Wisconsin Rapids, WI
• Providers in Wisconsin Rapids, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.

Verify at the official NPI Registry.