Randy Gene Misenheimer, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

1024917 Issued in TX

Practice address

7111 Bosque Blvd
Ste 101
Waco, TX 76710-4067

Phone

(254) 235-0708

Fax

(254) 693-7775

NPI assigned

Jul 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physical Therapy of Irving LTD

  • Physical Medicine & Rehabilitation Physician
  • Irving, TX
  • NPI 1821080870
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1679590699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 BOSQUE BLVD",
            "address_2": "STE 101",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104067",
            "telephone_number": "254-235-0708",
            "fax_number": "254-693-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 BOSQUE BLVD",
            "address_2": "STE 101",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104067",
            "telephone_number": "254-235-0708",
            "fax_number": "254-693-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISENHEIMER",
        "first_name": "RANDY",
        "middle_name": "GENE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1024917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey T Mims, PAAA
• Melanie Mims
• Mind Well Counseling, PLLC
• Minds Best Friend PLLC
• Kenneth Minor, NP
• Ajay Kumar Mishra
• Alexandra Justine Mitchell, MD
• Nitoshia Mitchell, HAIR LOSS SPECIALIST
• Steven D Mitchell, PHARM.D.
• Kimberly Mizerik

• Orthopedic Physical Therapist in Waco, TX
• Providers in Waco, TX by specialty
• Orthopedic Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.