DR. JOHN RANDALL BRANDT (PH.D.) – Clinical Psychologist, NPI 1033669080

DR. JOHN RANDALL BRANDT (PH.D.) is a healthcare provider. based in Springfield, Missouri. specializing in Clinical Psychologist. They hold the professional credentials PH.D.. They hold a License No. PY5269 (FL). The NPI Number for DR. JOHN RANDALL BRANDT (PH.D.) is 1033669080

Main info

Male
Sole Proprietor
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHN RANDALL BRANDT (PH.D.)
NPI
1033669080
Phone
(417) 269-6891
Address
3800 S NATIONAL AVE STE 770
Enumeration Date
13 October 2016
Last Update Date
27 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4172696880
Graduation Year
1993 (33 years ago)
PAC ID
1254691819
Group Practice PAC ID
5799787784
Professional Enrollment ID
I20180131000987
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:9State licenses:2Digital endpointsOther names

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Provider Addresses for DR. JOHN RANDALL BRANDT (PH.D.)

  • 770, South National Avenue, Rountree/Walnut, Springfield, Greene County, Missouri, 65804, United States

    SPRINGFIELD, MO 658075283

    Phone: (417) 269-6891

    Fax: (417) 269-5595

    Type: Location

  • Springfield, Boulevard Émile Krieps, Oberkorn, Differdange, Canton Esch-sur-Alzette, 4543, Luxembourg

    SPRINGFIELD, MO 658084046

    Phone: (417) 269-5712

    Fax: (417) 269-7567

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-01-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180131000987IClinical PsychologistMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 65807)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799787784View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. JOHN RANDALL BRANDT (PH.D.)?
DR. JOHN RANDALL BRANDT (PH.D.) — NPI 1033669080 — is the standard way to identify this listing.
Can I rely on DR. JOHN RANDALL BRANDT (PH.D.) being an active provider?
As of the registry snapshot, DR. JOHN RANDALL BRANDT (PH.D.) is marked active.
What is DR. JOHN RANDALL BRANDT (PH.D.)'s specialty?
The listing groups DR. JOHN RANDALL BRANDT (PH.D.) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for DR. JOHN RANDALL BRANDT (PH.D.)?
DR. JOHN RANDALL BRANDT (PH.D.)'s geographic hint is Springfield, Missouri in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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