Randy Edward Powell, LCAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

87000080A Issued in IN

Practice address

4755 Kingsway Dr Ste 105a
Indianapolis, IN 46205-1549

Phone

(317) 803-2270

NPI assigned

Dec 20, 2017

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: randy.powell.p1@direct.meridianhs.nextgenshare.com

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.

• Meridian Health Services Corp.

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1023603024
  NPD (past)

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1912413311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 KINGSWAY DR STE 105A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051549",
            "telephone_number": "317-803-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "RANDY",
        "middle_name": "EDWARD",
        "credential": "LCAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-20",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000080A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lora Powell, DPT
• Lynn Marie Powell
• Michael Powell
• Mishel Powell, LMHC
• Porsha Powell
• Raven Powell
• Tanesha Powell
• John Abram Powelson, MD
• Power Weight Loss Inc
• Andrew David Power, DDS

• Addiction (Substance Use Disorder) Counselor in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.