Active NPI
David Alan Randolph, M.D., PH.D.
- Neonatal-Perinatal Medicine Physician
- Birmingham, AL
National Provider Identifier
1114074051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- A79066
- Practice address
- 619 South 19TH Street
NHB 525
Birmingham, AL 35294 - Phone
- (205) 934-4680
- Fax
- (205) 934-3100
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | A79066 | CA | Primary |
Addresses
Primary practice location
619 South 19TH Street
NHB 525
Birmingham, AL 35294
Mailing address
PO Box 55823
Birmingham, AL 35255
Phone (205) 996-2244
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009910610 | Medicaid | AL | |
| 08909026 | Other | AL | MISSISSIPPI MEDICAID |
| 515-42016 | Other | AL | BC BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A79066 | CA | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HCA Healthone LLC | Past | Accepting new patients | |
| University of Alabama Health Services Foundation, PC. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Birmingham, AL
- NPI 1093768723
-
- General Acute Care Hospital
- Denver, CO
- NPI 1720038946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1114074051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55823",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35255",
"telephone_number": "205-996-2244",
"fax_number": "205-996-2254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 SOUTH 19TH STREET",
"address_2": "NHB 525",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35294",
"telephone_number": "205-934-4680",
"fax_number": "205-934-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDOLPH",
"first_name": "DAVID",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": "A79066",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009910610",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSISSIPPI MEDICAID",
"identifier": "08909026",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS",
"identifier": "515-42016",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.