TOMI RANDALL (NPI# 1710363031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710363031 |
| Entity Type | Individual |
| Full Name | TOMI RANDALL |
| Other Name | TOMI GRILLEY |
| Practice Address |
2901 Hunters Trl Portage WI 53901-3403 |
| Practice Telephone | 6087425518 |
| Practice Fax Number | 6087424087 |
| Mailing Telephone | 6087425518 |
| Mailing Fax Number | 6087424087 |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2018-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
7117-125 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1710363031 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1343 Park Ave, Columbus, WI 539251614 | 9206235578 | 9206239830 |
| 2910 New Pinery Rd, Unit A2, Portage, WI 539019292 | 6087454900 | 6087454990 |
| Street Address |
2901 HUNTERS TRL |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-3403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912973942 | Andrew Taylor Putney | Family Medicine | 2901 Hunters Trl, Portage, WI 53901-3403 | 2006-02-28 |
| 1164086112 | Claire A Staley | Social Worker | 2901 Hunters Trl, Portage, WI 53901-3403 | 2019-04-25 |
| 1467826990 | Renee Birkholz | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2015-11-20 |
| 1144618604 | Kristine G Schmitt | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2015-01-06 |
| 1700287216 | Jill Dickson-baures | Psychologist | 2901 Hunters Trl, Portage, WI 53901-3403 | 2014-09-16 |
| 1376944504 | Meredith Sullivan | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2014-09-08 |
| 1619377223 | Bjorn Hanson | Psychologist | 2901 Hunters Trl, Portage, WI 53901-3403 | 2014-09-02 |
| 1649697988 | Elizabeth Abbs Erickson | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2014-03-25 |
| 1124259841 | Robin A Deethardt | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2009-07-29 |
| 1881823912 | Dorothy Mae Mccurdy | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2009-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891357497 | Bluewater Counseling Services LLC | Counselor | 1611 W Centre Ave Ste 107, Portage, MI 49024-5339 | 2019-07-03 |
| 1275026247 | Chitradevi C Caradedios | Counselor | 8080 Moorsbridge Rd Ste 102, Portage, MI 49024-4422 | 2018-06-13 |
| 1417457391 | Family Counseling Services LLC | Counselor | 1611 W Centre Ave Ste 103, Portage, MI 49024-5339 | 2018-02-16 |
| 1487008926 | George O Otura | Counselor | 2150 Albatross Ct Apt 2d, Portage, MI 49024-2443 | 2016-04-21 |
| 1821454315 | Honey Sternberg | Counselor | 2910 New Pinery Rd Ste A2, Portage, WI 53901-9292 | 2016-01-13 |
| 1598139503 | Matthew David Bilchak | Counselor | 1007 Jefferson Ave, Portage, PA 15946-1710 | 2015-11-16 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1043635220 | Heather Jane Gove | Counselor | 2639 New Pinery Rd # 1, Portage, WI 53901-1110 | 2014-02-25 |
| 1154758787 | Obioha Collins Unaeze | Counselor | 5250 Lovers Ln Ste 200, Portage, MI 49002-1579 | 2013-09-27 |
| 1710250949 | Trinity Counseling Group | Counselor | 4566 Wishing Well Ct, Portage, MI 49024-4655 | 2012-02-19 |
| Find all providers in PORTAGE | ||||
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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.