RANDALL KENNETH SHIVELY (NPI# 1235608084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235608084 |
| Entity Type | Individual |
| Full Name | RANDALL KENNETH SHIVELY |
| Credential | PH.D, LICDC |
| Practice Address |
2100 Stella Ct Columbus OH 43215-1011 |
| Practice Telephone | 6142528402 |
| Practice Fax Number | 6142525326 |
| Mailing Telephone | 6142528402 |
| Mailing Fax Number | 6142525326 |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2018-11-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
975850 | OH | Behavioral Health & Social Service Providers |
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
4374 | OH | Behavioral Health & Social Service Providers |
| Street Address |
2100 STELLA CT |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43215-1011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295943702 | Misti Sellers | Student in an Organized Health Care Education/Training Program | 2100 Stella Ct, Columbus, OH 43215-1011 | 2007-05-18 |
| 1326660010 | Nicole Marie Johnson | Behavioral Analyst | 2100 Stella Ct, Columbus, OH 43215-1011 | 2020-05-15 |
| 1124676655 | Nellie M Remson | Counselor | 2100 Stella Ct, Columbus, OH 43215-1011 | 2019-08-28 |
| 1205495447 | Thomas Evan Boggs | Counselor | 2100 Stella Ct, Columbus, OH 43215-1011 | 2019-06-11 |
| 1487128088 | Ravon Ashley Johnson | Counselor | 2100 Stella Ct, Columbus, OH 43215-1011 | 2019-01-16 |
| 1386993350 | Alvis Inc | Community/Behavioral Health | 2100 Stella Ct, Columbus, OH 43215-1011 | 2012-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912529496 | Ade Elisha | Counselor | 61 West Long St, Columbus, OH 43215 | 2020-05-07 |
| 1073140083 | Ryan Jeffrey Stone | Student in an Organized Health Care Education/Training Program | 393 E. Town Street, #116, Columbus, OH 43215 | 2020-03-27 |
| 1316572316 | Covermymeds Specialty Pharmacy LLC | Pharmacy | 2 Miranova Pl 10th Fl, Suite 101, Columbus, OH 43215 | 2020-03-10 |
| 1902443807 | Nicole Marie Thompson | Social Worker | Southeast, Inc., 16 W Long St, Columbus, OH 43215 | 2019-12-10 |
| 1043852858 | Rachel Therese James | Licensed Practical Nurse | 1380 Dublin Rd Suite 100, Columbus, OH 43215 | 2019-10-14 |
| 1447804737 | Remington-davis, Inc. | Specialist | 1335 Dublin Road, Suite 106a, Columbus, OH 43215 | 2019-07-25 |
| 1346892619 | Nicole Nuxol Talley | Nurse Practitioner | 1335 Dublin Rd Ste 124-d, Columbus, OH 43215 | 2019-07-16 |
| 1730650664 | Sierra N White | Marriage & Family Therapist | 399 E. Main Street, Columbus, OH 43215 | 2018-12-17 |
| 1043798937 | David Benjamin Blankenbeckley | Nurse Practitioner | 3 Nationwide Plz Ste 150, Columbus, OH 43215 | 2018-08-01 |
| 1891272795 | Tiffany Mindigo | Nurse Practitioner | 1335 Dublin Rd Ste 114e, Columbus, OH 43215 | 2018-07-24 |
| Find all providers in zip 43215 | ||||
| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295156263 | Angelice Morgan | Psychologist | 506 Manchester Expressway, Columbus, GA 31904 | 2013-12-18 |
| 1982025045 | Amber Harrow | Psychologist | 506 Manchester Expy Ste A13and14, Columbus, GA 31904-6444 | 2013-12-17 |
| 1831524917 | Abigail Chiwandamira | Psychologist | 6113 Chestnut Ridge Dr, Columbus, OH 43230-8311 | 2013-09-09 |
| 1962613760 | Susan Narwicz Sherwood | Psychologist | 2879 Johnstown Road, Columbus, OH 43219 | 2007-05-24 |
| 1992188577 | Jenna Kern | Psychologist | 5000 Arlington Centre Blvd, Columbus, OH 43220-3075 | 2015-07-01 |
| 1821497801 | Judy Davis | Psychologist | 2100 Comer Ave, 1230 2nd Ave, Columbus, GA 31904-8725 | 2014-08-15 |
| 1699184796 | Terry Bruce | Psychologist | 1230 2nd Ave, Columbus, GA 31901-5241 | 2014-08-04 |
| 1255594859 | Amanda Sanford | Psychologist | 2100 Comer Ave, Columbus, GA 31904-8725 | 2008-07-03 |
| 1962615401 | Douglas Carter Mcelwain | Psychologist | 1660 Nw Professional Plz, Suite F, Columbus, OH 43220-3854 | 2007-05-08 |
| 1760410898 | Susan Marie Havercamp | Psychologist | 1581 Dodd Drive, Suite 300, Columbus, OH 43210-1240 | 2006-06-29 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.