Randall Josiah Bosley
Individual provider Active NPI Family Medicine Physician · Connelly Springs, NC
NPI 1013650407 · NPPES record last updated Sep 8, 2025
Key facts
- NPI
- 1013650407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2025-02457 (NC)
- Practice address
- 730 Malcolm Blvd Ste 150
Connelly Springs, NC 28612-8079 - Phone
- (828) 874-4600
- Fax
- (828) 580-8459
- NPI assigned
- Apr 14, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Blue Ridge Healthcare Medical Group Inc
Practice addresses (Care Compare)
730 Malcolm Blvd
Suite 150
Connelly Springs, NC 28612-8079
Phone (828) 874-4600
Hospital & facility affiliations
- Gentiva Health Services
- Blue Ridge Healthcare Hospitals, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250926002684 | NC | Practitioner - Family Practice | 8224533476 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2025-02457 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | Current |
Accepting new patients |
| Blue Ridge Healthcare Medical Group, Inc. | Current | Accepting new patients | |
| Blue Ridge Healthcare Medical Group, Inc. | Current |
Accepting new patients | |
| Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | Past | Accepting new patients |
Locations
2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393
Interoperability endpoints
- rbosley1304720@direct.unc.nchie.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2025-02457 | NC | Yes |
Addresses
Primary practice location
730 Malcolm Blvd Ste 150
Connelly Springs, NC 28612-8079
Mailing address
5221 Paramount Pkwy Ste 420
Morrisville, NC 27560-5491
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rbosley1304720@direct.UNC.nchie.net | Direct |
Other providers in Connelly Springs, NC
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Healthcare Medical Group, Inc.
- Blue Ridge Medical Group, Inc
- Dana Nicole Brown
- Janet Cannon Byers
- Carnaggio and Piper DMD Ms PA
- Carolina Burke Operator LLC
- College Pines Rehabilitation and Skilled Nursing Center, LLC
All providers in Connelly Springs, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.