Randall Terence Drain Sr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD039729L Issued in PA

Practice address

4035 Powelton Ave
Philadelphia, PA 19104-2262

Phone

(215) 471-7000

Fax

(215) 474-0457

NPI assigned

Nov 21, 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)

Not enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Pediatric & Preventive Medicine Assoc PC

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1447311576
  NPD (past) Authorized official

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1205901949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3847 NORTH SYDENHAM STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "215-227-3300",
            "fax_number": "215-227-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 POWELTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042262",
            "telephone_number": "215-471-7000",
            "fax_number": "215-474-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAIN",
        "first_name": "RANDALL",
        "middle_name": "TERENCE",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD039729L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1054660",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodney Brent Drafts
• John Michael Draganescu, MD
• Rossitza Anguelova Draganova-Tacheva, M.D.
• Jennifer Marie Dragoun, MD
• Lindsay Ann Draham, CRNP
• Retania Drain, MS
• Colin A Drake, PAC
• Kim Drake
• Lesa Drake
• Mallory Blaine Drake, MPH, RDN, LDN, CHES

• Pediatrics Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.