Randall Earl Bundy

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

RANDALL EARL BUNDY

Practice address

510 Bluff Ave
Brainerd, MN 56401-2653

Phone

(218) 829-1063

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Randy Earl Bundy, LP

Title

Owner

Phone

(218) 829-1063

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217548800000",
    "number": "1649367806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 BLUFF AVE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012653",
            "telephone_number": "218-829-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BLUFF AVE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012653",
            "telephone_number": "218-829-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL EARL BUNDY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "BUNDY",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-829-1063",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9050AD",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "122361",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "5066093",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8115555100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley James Qualey, MD
• Christina Annette Quigley
• Rainbow of Health Physical Therapy, Inc.
• Rainbow Therapeutics, Inc.
• Kristin Lillian Rajala, D.D.S.
• Katherine E Rangen, PHARM D
• Teah Gloria Mae Rardin, OT
• Maria Josephine Rauch, LPN
• Redebaugh Chiropractic, P.a.
• Redefyne

• Psychologist in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.

Verify at the official NPI Registry.