Active NPI
Randall Wayne Hoffman, LADC
- Addiction (Substance Use Disorder) Counselor
- Preston, MN
National Provider Identifier
1720110406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 301276
- Practice address
- 124 Main Street
Preston, MN 55965 - Phone
- (507) 765-2505
- Fax
- (507) 765-2252
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 301276 | MN | Primary |
Addresses
Primary practice location
124 Main Street
Preston, MN 55965
Mailing address
217 Plum St
Armory Center Suite 220
Red Wing, MN 55066-2351
Phone (651) 388-2090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 301276 | MN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720110406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 PLUM ST",
"address_2": "ARMORY CENTER SUITE 220",
"city": "RED WING",
"state": "MN",
"postal_code": "550662351",
"telephone_number": "651-388-2090",
"fax_number": "351-388-2129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 MAIN STREET",
"city": "PRESTON",
"state": "MN",
"postal_code": "55965",
"telephone_number": "507-765-2505",
"fax_number": "507-765-2252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOFFMAN",
"first_name": "RANDALL",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "301276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Preston, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.