OrganizationActive
Random Lake Spine & Sports Clinic
NPI 1659543205 · Clinic/Center · Random Lake, WI
Random Lake Spine & Sports Clinic is a Clinic/Center organization in Random Lake, WI (NPI 1659543205).
Provider details
- NPI number
- 1659543205
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jason Rudelich, President(920) 994-2000
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
321 Carroll St.
Random Lake, WI 53075
Phone: (920) 994-2000
Street-level locationGet directions
Mailing address
Po Box 196
Random Lake, WI 53075-0196
Registry dates
- Enumerated
- 2008-03-24
- Last updated
- 2008-06-02
Frequently asked questions
- What is Random Lake Spine & Sports Clinic's NPI number?
- Random Lake Spine & Sports Clinic's National Provider Identifier (NPI) is 1659543205, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Random Lake Spine & Sports Clinic?
- Random Lake Spine & Sports Clinic is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Random Lake Spine & Sports Clinic located?
- Random Lake Spine & Sports Clinic's practice location on file with NPPES is 321 Carroll St., Random Lake, WI 53075.
- What is Random Lake Spine & Sports Clinic's phone number?
- The practice phone number listed in the NPPES registry for Random Lake Spine & Sports Clinic is (920) 994-2000.
- Who is the authorized official for Random Lake Spine & Sports Clinic?
- The authorized official listed on Random Lake Spine & Sports Clinic's NPPES record is Jason Rudelich, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Random Lake Spine & Sports Clinic's NPI active?
- Yes — Random Lake Spine & Sports Clinic's NPI (1659543205) is active in the NPPES registry as of the last update on 2008-06-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.