Individual provider Active NPI

Randy Joseph Rau, DNP, FNP-C

  • Family Nurse Practitioner
  • Manton, MI
National Provider Identifier
1770985343
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704410533 Issued in MI
Practice address
6876 W Phelps Rd
Manton, MI 49663-9056
Phone
(147) 968-0086
NPI assigned
Sep 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704410533 MI Primary

Addresses

Primary practice location

6876 W Phelps Rd
Manton, MI 49663-9056

Mailing address

26 SW Deyo Landing Loop
Cache, OK 73527-3278
Phone (810) 922-3592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20240422000572 MI Practitioner - Nurse Practitioner 1355788282 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704410533MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Hometown Urgent Care of Michigan, PC CurrentSince May 20, 2024 Accepting new patients
Pic Indiana PC CurrentSince May 1, 2024 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince May 20, 2024 Accepting new patients

Locations

1131 M 32 W
Alpena, MI 49707
Phone (989) 250-1925

25 Columbia Ave E
Battle Creek, MI 49015
Phone (269) 425-3017

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

3570 N US 31 S
Traverse City, MI 49684
Phone (231) 486-2573

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1770985343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SW DEYO LANDING LOOP",
            "city": "CACHE",
            "state": "OK",
            "postal_code": "735273278",
            "telephone_number": "810-922-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6876 W PHELPS RD",
            "city": "MANTON",
            "state": "MI",
            "postal_code": "496639056",
            "telephone_number": "147-968-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAU",
        "first_name": "RANDY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-25",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704410533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manton, MI

Sources for this page

Verify at the official NPI Registry.