Kourtney Randsdorp, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC012565 Issued in PA

Practice address

105 Heritage Rd
Lancaster, PA 17602

Phone

(717) 572-7966

NPI assigned

Nov 15, 2012

Last updated

May 30, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kourtney Heichel Former name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Freedom LLCGroup PAC ID 6406104728, 5 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Functional Freedom LLC

  • Occupational Therapist
  • Lancaster, PA
  • NPI 1861989493
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1710221668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HERITAGE RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176021597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HERITAGE RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "17602",
            "telephone_number": "717-572-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDSDORP",
        "first_name": "KOURTNEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC012565",
            "primary": true
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "NJ",
            "license": "46TR00592700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KOURTNEY",
            "last_name": "HEICHEL",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria Ranck
• Meridith Ranck
• Veronica K Ranck, MSW,LCSW
• Randali Medical Associates P.C. (Randali)
• Gina M Randazzo, SLP
• Carmelie Rank, LCSW
• Jessica S Rank, CRNP
• Melanie Rankin
• Diane E Rapisardo, LCSW
• Terri Lynne Rapp, M.D.

• Occupational Therapist in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.