Individual provider Active NPI

Nicholas Ryan Randolph, D.C

  • Chiropractor
  • Huntington Beach, CA
National Provider Identifier
1083355143
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
34913 Issued in CA
Practice address
7071 Warner Ave Ste C
Huntington Beach, CA 92647-5444
Phone
(313) 378-6702
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 34913 CA Primary

Addresses

Primary practice location

7071 Warner Ave Ste C
Huntington Beach, CA 92647-5444

Mailing address

1764 E Broadway Apt 1
Long Beach, CA 90802-3711
Phone (313) 378-6702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241217001928 CA Practitioner - Chiropractic 5991232837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1559 Pacific Coast Hwy
Suite 105
Hermosa Beach, CA 90254-3214
Phone (424) 424-7243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34913CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
100 Chiropractic Helfrich HB Inc Chiropractor CurrentSince Sep 24, 2023 Accepting new patients
Helfrich Chiropractic Hermosa Beach PC Chiropractor CurrentSince Nov 1, 2024 Accepting new patients
100 Chiropractic Grant HB Inc Chiropractor CurrentSince Jul 1, 2025 Accepting new patients

Locations

1559 Pacific Coast Hwy
Ste 105
Hermosa Beach, CA 90254
Phone (318) 780-1737

7071 Warner Ave
Ste C
Huntington Beach, CA 92647
Phone (313) 378-6702

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1083355143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 E BROADWAY APT 1",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908023711",
            "telephone_number": "313-378-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7071 WARNER AVE STE C",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475444",
            "telephone_number": "313-378-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.