Randall Wade McKenna, DO

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

J0118 Issued in TX

Practice address

1713 S FM 51
Suite 103
Decatur, TX 76234

Phone

(940) 627-6976

Fax

(940) 627-3491

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Opted out of Medicare

Yes, effective Oct 1, 2026 through Oct 1, 2028

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hillorthopediccenterllc.rwademckenna@124772.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Central Texas Orthopaedics and Sports Medicine PA

  • Orthopaedic Surgery Physician
  • Trophy Club, TX
  • NPI 1194781773
  Medicare reassignment NPD Authorized official
• Center for Urologic Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Saint Louis, MO
  • NPI 1093230450
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1063477552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 S FM 51",
            "address_2": "SUITE 103",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "76234",
            "telephone_number": "940-627-6976",
            "fax_number": "940-627-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 S FM 51",
            "address_2": "SUITE 103",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "76234",
            "telephone_number": "940-627-6976",
            "fax_number": "940-627-3491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 E Highway 114 Ste 130",
            "address_purpose": "LOCATION",
            "city": "Trophy Club",
            "state": "TX",
            "postal_code": "762625305",
            "country_code": "US",
            "telephone_number": "469-916-4435",
            "fax_number": "940-687-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "RANDALL",
        "middle_name": "WADE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "J0118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131938605",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "89Z590",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cherissa McConnell, LMSW
• Alicia McCue, FNP
• Brenda Jean McDonnell, AGPCNP-BC
• Chris E McGee, MD
• McKenna Orthopaedic and Sports Medicine PA
• Shanique McKittrick, PMHNP-BC
• McLean R Sanborn, MD, PA
• Sharon G McLemore, NP
• Kassi Jean McPherson, D.C., M.S.
• Michele Leane McPherson, FNP

• Orthopaedic Surgery Physician in Decatur, TX
• Providers in Decatur, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.