Mackenzie Randolph

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1231411 Issued in TX

Practice address

3133 E Lemmon Ave
Dallas, TX 75204-1411

Phone

(214) 599-2108

NPI assigned

Oct 29, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Minuteclinic Diagnostic of Texas PLLC

  • Family Nurse Practitioner
  • Round Rock, TX
  • NPI 1609076330
  Medicare reassignment
• Minuteclinic Primary Care Texas PLLC

  • Family Nurse Practitioner
  • Spring, TX
  • NPI 1710794292
  Medicare reassignment

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1073482014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 E LEMMON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041411",
            "telephone_number": "817-599-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 E LEMMON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041411",
            "telephone_number": "214-599-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1231411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Blake Randles, PA-C
• Lauren Lindsey Rando
• Diane R. Randolph, FNP-BC
• Janet Eileen Randolph, CRNA
• Kinzie Nicole Randolph
• Miah Randolph, LPC
• Clarissa Rane
• Mihir N Rane, D.O.
• Aubry Raney, B.S.CNIM
• Kenneth Carter Raney, MD

• Family Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.