Randall Andrew Bottelson, BS

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

Practice address

601 W 98TH St
Bloomington, MN 55420-4715

Phone

(952) 881-2778

Fax

(952) 881-2821

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

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)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801949276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 98TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204715",
            "telephone_number": "952-881-2778",
            "fax_number": "952-881-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 98TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554204715",
            "telephone_number": "952-881-2778",
            "fax_number": "952-881-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTELSON",
        "first_name": "RANDALL",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Marie Bosma, DPT
• Kiana Laureli Boston
• Jared Brent Bostrom, LMFT, LADC, CPRP
• Elijah E Boswell
• Bottelson Enterprises
• John William Bottoms, PT
• Lisa Paull Boudreau
• Mark Boudreau, PHARMD
• Mouktar Bouraleh
• Christina Danielle Bourgeois, LPCC

• Prosthetics Case Management in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Prosthetics Case Management in Minnesota

• 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.

Verify at the official NPI Registry.