Active NPI
Randall Verhdek Oftedahl
- Social Worker
- Cranston, RI
National Provider Identifier
1821272303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ISW01913
- Practice address
- 744 Park Ave
Cranston, RI 02910-2150 - Phone
- (401) 338-7277
- NPI assigned
- Dec 20, 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | ISW01913 | RI | Primary |
Addresses
Primary practice location
744 Park Ave
Cranston, RI 02910-2150
Mailing address
744 Park Ave
Cranston, RI 02910-2150
Phone (401) 338-7277
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RO53435 | Medicaid | RI |
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 |
|---|---|---|---|
| ISW01913 | RI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228780800000",
"number": "1821272303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "744 PARK AVE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029102150",
"telephone_number": "401-338-7277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "744 PARK AVE",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029102150",
"telephone_number": "401-338-7277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OFTEDAHL",
"first_name": "RANDALL",
"middle_name": "VERHDEK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-20",
"last_updated": "2008-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "RI",
"license": "ISW01913",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RO53435",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.