Jared Thomas Randolph

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A02450 Issued in KY

Practice address

1614 W Parrish Ave
Owensboro, KY 42301-3535

Phone

(270) 684-4559

NPI assigned

Jan 23, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1642896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642896000000",
    "number": "1225780034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 DANIELS LN",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039675",
            "telephone_number": "270-929-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 W PARRISH AVE",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423013535",
            "telephone_number": "270-684-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "JARED",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-23",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KY",
            "license": "A02450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Rafferty, PHARMD
• Sarah T Raines, PHARMD
• David J. Ralston, PHD, LCCC, ATC
• Ramez a Salamah MD PLLC
• Tabitha Ramos, CSW
• Randy J Cox,Mdpsc
• Randy L Wolfe, MD
• Hannah Taylor Ransom, APRN
• Jessica L Raque, M.D.
• Saman Rashid, MD

• Physical Therapy Assistant in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Physical Therapy Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; 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.