Randell Leon Elkins Jr., PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY000948 Issued in GA

Practice address

701 Broad St Ste 350
Rome, GA 30161-3092

Phone

(706) 295-2028

Fax

(706) 295-2062

NPI assigned

Dec 9, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Harbin Clinic, LLC

  • Ambulatory Surgical Clinic/Center
  • Rome, GA
  • NPI 1447385158
  NPD

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1194885475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BROAD ST STE 350",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613092",
            "telephone_number": "706-295-2028",
            "fax_number": "706-295-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKINS",
        "first_name": "RANDELL",
        "middle_name": "LEON",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY000948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000493083B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Lawrence Edwards, DMD
• Seth Francis Einterz, M.D.
• Rick Iffie Ejifoma, PHARM D
• Amarachukwu Ejime, DNP
• Cynthia Ekwem, P.A
• Ellington Eyecare PLLC
• Kent C Ellington, DMD
• Hayden Ellis, OT
• Stephen Robert Elmer, DPT
• Melanie Ann Emery, WHNP-BC

• Clinical Psychologist in Rome, GA
• Providers in Rome, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.