Randi Hagen, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.0032485 Issued in OH

Practice address

9049 Springboro Pike
Miamisburg, OH 45342-4926

Phone

(937) 759-0545

NPI assigned

Apr 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Randi Edens Former name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Woodstream WellnessGroup PAC ID 8527462506, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Woodstream Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Miamisburg, OH
  • NPI 1265001234
  Medicare reassignment Care Compare group
• WS Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Miamisburg, OH
  • NPI 1225710668

  Single Specialty

  NPD

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1760126221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9049 SPRINGBORO PIKE",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453424926",
            "telephone_number": "513-349-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9049 SPRINGBORO PIKE",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453424926",
            "telephone_number": "937-759-0545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9049 Springboro Pike",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453424926",
            "country_code": "US",
            "telephone_number": "937-759-0545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "RANDI",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN.388342",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0032485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDI",
            "last_name": "EDENS",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jena Greiner
• Lindsay Grills
• Jerod B Grogg, PA
• Stephanie Renee Habermehl, BCBA
• Jourdan Hagedorn, FNP-C
• Hagerty & Mazzola D.D.S., Inc
• Shelly Renee Haggard
• David C. Hall, D.D.S.
• Tara Hall
• Michelle Halton, CPNP

• Psychiatric/Mental Health Nurse Practitioner in Miamisburg, OH
• Providers in Miamisburg, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.