Individual provider Active NPI

Randy D Readling, M.D.

  • Psychiatry Physician
  • Appleton, WI
National Provider Identifier
1952361610
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
93-00292 Issued in NC
Practice address
320 S Walnut St
Appleton, WI 54911-5918
Phone
(920) 832-5270
Fax
(920) 832-4767
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036.147764 IL
Psychiatry Physician 2084P0800X 1160 WI
Psychiatry Physician 2084P0800X 93-00292 NC Primary

Addresses

Primary practice location

320 S Walnut St
Appleton, WI 54911-5918

Mailing address

4525 N Ravenswood Ave Ste 201
Chicago, IL 60640-5201
Phone (312) 857-8794

Other identifiers 4

IdentifierTypeStateIssuer
9300292OtherNCNC MEDICAL LICENSE
036.147764OtherILIL MEDICAL LICENSE
1160OtherWIWI MEDICAL LICENSE
93-00292OtherNCMEDICAL LICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address midwestmedical@midwestmedicalcenter.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL, WI3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060517000005 NC Practitioner - Psychiatry 9931110434 Practice locations: Greensboro, NC; Newton, NC
I20201210002596 IL Practitioner - Psychiatry 9931110434 Reassigns benefits to 1 organization
I20210316002757 WI Practitioner - Psychiatry 9931110434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of OutagamieGroup PAC ID 7517930019, 9 clinicians

Practice addresses (Care Compare)

320 S Walnut St
Appleton, WI 54911-5918
Phone (920) 832-1624

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1160WIMDMarriage & Family Therapist
036.147764ILMDPsychiatry Physician
93-00292NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Outagamie CurrentSince Jan 28, 2021 Accepting new patients
Midwest Medical Center CurrentSince Oct 20, 2020 Accepting new patients
Midwest Medical Center CurrentSince Oct 20, 2020 Accepting new patients
Department of Veterans Affairs Past Accepting new patients

Locations

1 Medical Center Dr
Galena, IL 61036
Phone (815) 776-7381

320 S Walnut St
Appleton, WI 54911
Phone (920) 832-1624

Interoperability endpoints

  • Direct secure messaging: midwestmedical@midwestmedicalcenter.cernerdirect.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1952361610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 N RAVENSWOOD AVE STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405201",
            "telephone_number": "312-857-8794",
            "fax_number": "708-575-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S WALNUT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-5270",
            "fax_number": "920-832-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "READLING",
        "first_name": "RANDY",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.147764",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "1160",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "93-00292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAL LICENSE",
            "identifier": "9300292",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL MEDICAL LICENSE",
            "identifier": "036.147764",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI MEDICAL LICENSE",
            "identifier": "1160",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "93-00292",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "midwestmedical@midwestmedicalcenter.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Midwest Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1 Medical Center Dr",
            "city": "Galena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610368118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.