Randall L Midock, PHD

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

0803000079 Issued in VA

Practice address

801 S Loudoun Street
Winchester, VA 22601

Phone

(540) 667-5431

Fax

(540) 667-2655

NPI assigned

Sep 2, 2006

Last updated

May 29, 2008By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Psychological Health Associates

  • Psychologist
  • Winchester, VA
  • NPI 1417039264
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1174625750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DICK TURPIN COURT",
            "city": "STEPHENS CITY",
            "state": "VA",
            "postal_code": "22655",
            "telephone_number": "540-869-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S LOUDOUN STREET",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22601",
            "telephone_number": "540-667-5431",
            "fax_number": "540-667-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDOCK",
        "first_name": "RANDALL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "VA",
            "license": "0803000079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH",
            "identifier": "088289",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "211030",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal-Luba Nondumiso Mhlophe, PHARMD
• Barry L Michael, PA
• Hennessee Alicia Michals
• Donna M Michel, MD
• Michon Bechamps, MD, PLC
• Hannah Mierjeski
• Alexis Mierzwa, DDS
• Alayna Mihill
• Joseph L Mikus, MD
• Nikolas Sean Mikus, AU.D.

• School Psychologist in Winchester, VA
• Providers in Winchester, VA by specialty
• School Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.