NPIMap

Organization Active NPI

John F. Randolph,M.D.,Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Colton, CA
National Provider Identifier
1063567394
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
JOHN F. RANDOLPH,M.D.,INC.
Practice address
400 North Pepper Avenue
Colton, CA 92324-1819
Phone
(909) 580-1675
Fax
(909) 580-1916
NPI assigned
Jan 25, 2007
Last updated
Dec 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Authorized official

Name
Dr. John Franklin Randolph, M.D.
Title
President
Phone
(909) 580-6260

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

400 North Pepper Avenue
Colton, CA 92324-1819

Mailing address

PO Box 7779
Redlands, CA 92375-0779
Phone (909) 580-6260

Other identifiers 1

IdentifierTypeStateIssuer
GR0065470MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261094400000",
    "number": "1063567394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7779",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923750779",
            "telephone_number": "909-580-6260",
            "fax_number": "909-580-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NORTH PEPPER AVENUE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-580-1675",
            "fax_number": "909-580-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN F. RANDOLPH,M.D.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-12-18",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-580-6260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.