Randall Shively, PH.D, LICDC
Randall Shively, PH.D, LICDC is an Intellectual & Developmental Disabilities Psychologist in Columbus, OH, registered under NPI 1235608084. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 2100 STELLA CT, Columbus, OH 43215. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 4374 | OH | Intellectual & Developmental Disabilities… primary |
| 975850 | OH | Addiction (Substance Use Disorder)… |
This provider holds licence 4374 issued in OH. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Intellectual & Developmental Disabilities covers
Definition to come... NUCC Health Care Provider Taxonomy, code 103TM1800X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 103TM1800X | Intellectual & Developmental Disabilities Psychologist Intellectual & Developmental Disabilities | 4374 | OH | primary |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor Addiction (Substance Use Disorder) | 975850 | OH |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1235608084 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Nov 21, 2018 |
| Last updated | Apr 25, 2023 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | PH.D, LICDC |
| Practice address |
2100 STELLA CT Columbus, OH 43215 (614) 252-8402 Fax (614) 252-5326 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 2 | 3 | 5 | 6 | 0 | 8 | 0 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 2 | 6 | 5 | 3 | 0 | 7 | 0 | 7 |
Sum = 56 · next multiple of 10 = 60 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.