MARK RANDALL SMITH (NPI# 1790779775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790779775 |
| Entity Type | Individual |
| Full Name | MARK RANDALL SMITH |
| Credential | PHD |
| Practice Address |
904 Hwy 15 South Frontage Rd. Suite H Hutchinson MN 55350 |
| Practice Telephone | 3205872939 |
| Practice Fax Number | 3208641927 |
| Mailing Telephone | 3205872939 |
| Mailing Fax Number | 3208641927 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2008-10-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP2907 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CHOICE PLUS | 112964 | 01 | |
| HEALTH PARTNERS | 24981 | 01 | |
| PRIME WEST HEALTH SYST | 030701079 | 01 | |
| UNITED BEH HEALTH | 6120057 | 01 | |
| AETNA | 0004049 | 01 | |
| MN | UCARE | 115129 | 01 |
| MN | 262248300 | 05 | |
| MN | BC | 53308SM | 01 |
| PREFERRED ONE/BHP | 990991000146 | 01 | |
| IA | BC | 98520 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871025668 | Mark Robert Smith | Physical Therapist | 11448 Princessa Ln, Jacksonville, FL 32218-4054 | 2017-03-30 |
| 1982148565 | Mark Smith Jr. | Pharmacist | 2850 Venice Rd Sw, Apt 3303, Birmingham, AL 35211-6203 | 2016-12-15 |
| 1396124558 | Mark Andrew Smith | Physical Therapist | 125 S Mcdaniel Dr, Auburn, CA 95603-5742 | 2015-05-21 |
| 1760875181 | Mark Smith | Case Manager/Care Coordinator | 4028 Knollton Rd, Indianapolis, IN 46228-3332 | 2015-03-09 |
| 1366833154 | Mark James Smith | Pharmacist | 2627 Oneida St, Utica, NY 13501-6332 | 2015-02-15 |
| 1568869824 | Mark Smith | Occupational Therapy Assistant | 1160 Old State Rd, New Castle, PA 16101-6417 | 2014-12-01 |
| 1992128581 | Mark Harrison Smith | Case Manager/Care Coordinator | 346 Sycamore Ridge Way, Gahanna, OH 43230-5605 | 2014-02-03 |
| 1881967263 | Mark Steven Smith | Dentist | 7685 Wolf River Cir Ste 102, Germantown, TN 38138-1749 | 2012-02-16 |
| 1225328768 | Mark W Smith | Counselor | 2619 W. 6th St, Suite C, Lawrence, KS 66049 | 2011-04-18 |
| 1053628271 | Mark Thomas Smith | Optometrist | 592 Main St N, Mc Kenzie, TN 38201-1707 | 2010-09-09 |
| Street Address |
904 HWY 15 SOUTH FRONTAGE RD. SUITE H |
| City | HUTCHINSON |
| State | MN |
| Zip Code | 55350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063971521 | Carrie Morgando | Counselor | 255 Minnesota 7, Hutchinson, MN 55350 | 2019-03-14 |
| 1790243046 | Thrifty Drug Stores Inc | Durable Medical Equipment & Medical Supplies | 1460 Montreal St, Hutchinson, MN 55350 | 2019-03-06 |
| 1376013953 | Complete Assessments LLC | Rehabilitation, Substance Use Disorder Unit | 340 5th Ave Sw, Hutchinson, MN 55350 | 2018-11-27 |
| 1891283743 | Abby Ann Trettin | Optometrist | 1059 Mn-15, Hutchinson, MN 55350 | 2018-04-26 |
| 1154862142 | Serena Roehl | Specialist/Technologist | 150 Orchard Ave Se, Hutchinson, MN 55350 | 2017-03-10 |
| 1093264616 | Jessica Munsch | Occupational Therapist | 544 Prospect St. Ne, Hutchinson, MN 55350 | 2016-09-23 |
| 1962835777 | Jacqui Marie Ruzicka | Counselor | 255 Highway 7 E, Hutchinson, MN 55350 | 2013-08-15 |
| 1023455243 | Actively Living Life Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1187 Blackhawk Dr Sw, Hutchinson, MN 55350 | 2013-05-29 |
| 1669711966 | Stacy Marie Vancura | Counselor | 902 Highway 15 S Ste 200, Hutchinson, MN 55350 | 2013-02-06 |
| 1619226040 | Samantha Heather Stevens | Registered Nurse | 246 S. Main St., Prairie River Home Care, Hutchinson, MN 55350 | 2012-08-30 |
| Find all providers in zip 55350 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649550096 | Jarrod E Decter | Psychologist | 125 W 2nd Ave Ste E, Hutchinson, KS 67501-5263 | 2011-08-17 |
| 1659494516 | Samuel Richard Scholl | Psychologist | 712 Shady Ridge Rd Nw, Hutchinson, MN 55350-1414 | 2007-04-07 |
| 1336529627 | Chandler N Whaley | Psychologist | 1600 N Lorraine St, Ste 200, Hutchinson, KS 67501-5670 | 2015-06-02 |
| 1851640841 | Michael R Gallagher | Psychologist | 1600 N Lorraine St, Suite 202, Hutchinson, KS 67501-5670 | 2012-09-05 |
| 1841565819 | Barbara Gombosi | Psychologist | 1600 N Lorraine St, 202, Hutchinson, KS 67501-5670 | 2012-03-09 |
| 1265694004 | Mary Kathleen Flynn | Psychologist | 1600 N Lorraine St, Suite 202, Hutchinson, KS 67501-5670 | 2008-07-01 |
| 1053407015 | Tapatha K Strickler | Psychologist | 1715 E 23rd Ave, Hutchinson, KS 67502-1105 | 2006-10-05 |
| 1255438123 | Delmer H Thibault | Psychologist | 1715 E 23rd Ave, Hutchinson, KS 67502-1105 | 2006-09-20 |
| 1316043078 | Jamie Rose Burns | Psychologist | 1600 N Lorraine St, Suite 202, Hutchinson, KS 67501-5670 | 2006-09-16 |
| 1881790624 | Lyndal Penner | Psychologist | 1715 E 23rd Ave, Hutchinson, KS 67502-1105 | 2006-09-16 |
| Find all providers in HUTCHINSON | ||||
| City | HUTCHINSON |
| Zip Code | 55350 |
Please comment or provide details below to improve the information on MARK RANDALL SMITH.
| 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.