Randall Wayne Lish, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3170 Issued in MN

Practice address

3315 Bemidji Ave N
Bemidji, MN 56601-4330

Phone

(218) 444-2225

Fax

(218) 444-7225

NPI assigned

Nov 9, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Complete Health PC

  • Chiropractor
  • Bemidji, MN
  • NPI 1063176790
  Medicare reassignment NPD Authorized official

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

• Sanford Health of Northern Minnesota

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149

  Hospital

  Care Compare affiliation
• Sanford Health of Northern Minnesota

  • Rural Acute Care Hospital
  • Bemidji, MN
  • NPI 1801870191
  Care Compare affiliation

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952471633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 BEMIDJI AVE N",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014330",
            "telephone_number": "218-444-2225",
            "fax_number": "218-444-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 BEMIDJI AVE N",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014330",
            "telephone_number": "218-444-2225",
            "fax_number": "218-444-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISH",
        "first_name": "RANDALL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "78B72LI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tessa Lindberg, OTR/L
• Lindell Consulting, LLC
• Tami Dawn Lindell, DNP, FNP, GNP, PMHNP
• Jill Lindholm, LADC
• Cody Link, OTR/L
• Susanna Joy Little Elk, APRN, CNP
• Brian Paul Livermore, M.D.
• Sarah Marie Lofgren, MD
• Amanda M. Longie, MAPC, MAHR, LADC
• Andrea May Lucca, LICSW

• Chiropractor in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.