Individual provider Active NPI

Randee L Poeppelman, LCSW

  • Clinical Social Worker
  • Winter Garden, FL
National Provider Identifier
1619223542
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12688 Issued in FL
Practice address
13275 W Colonial Dr
Winter Garden, FL 34787-3984
Phone
(407) 905-8827
Fax
(407) 654-4079
NPI assigned
Jul 30, 2012
Last updated
Jul 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X SW12688 FL Primary

Addresses

Primary practice location

13275 W Colonial Dr
Winter Garden, FL 34787-3984

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

Other identifiers 1

IdentifierTypeStateIssuer
016974400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160328000198 FL Practitioner - Clinical Social Worker 2365667714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers, IncGroup PAC ID 4082515390, 46 clinicians

Practice addresses (Care Compare)

13275 W Colonial Dr
Winter Garden, FL 34787-3984
Phone (407) 905-8827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW12688FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers, Inc Current Accepting new patients
Community Health Centers, Inc CurrentSince Feb 22, 2016 Accepting new patients
Community Health Centers, Inc Current Accepting new patients
Community Health Centers, Inc CurrentSince Feb 22, 2016 Accepting new patients
Butler County Community Health Consortium, Inc. PastSince Oct 10, 2021 Accepting new patients

Locations

225 E 7th St
Apopka, FL 32703
Phone (407) 886-6201

225 N 1st St
Leesburg, FL 34748
Phone (352) 314-7400

7900 Forest City Rd
Orlando, FL 32810
Phone 40790588271001

7912 Forest City Rd
Orlando, FL 32810
Phone (407) 988-1075

840 Mercy Dr
Pine Hills, FL 32808
Phone 4079058827 ext. 2997

110 S Woodland St
Winter Garden, FL 34787

13275 W Colonial Dr
Winter Garden, FL 34787
Phone (407) 614-5374

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: randee.poeppelman@chcfl.eclinicaldirectplus.com

Organizations & group practices 5

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": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1619223542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "407-654-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13275 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873984",
            "telephone_number": "407-905-8827",
            "fax_number": "407-654-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POEPPELMAN",
        "first_name": "RANDEE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016974400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.