Individual provider Active NPI

Randy Estacion Florendo, MD

  • Emergency Medicine Physician
  • Springfield, TN
National Provider Identifier
1235124207
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD31309 Issued in TN
Practice address
832 Savannah West CT
Suite F
Springfield, TN 37172
Phone
(615) 483-6675
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD31309 TN
Emergency Medicine Physician 207P00000X MD31309 TN Primary
Emergency Medicine Physician 207P00000X 49518 KY
Internal Medicine Physician 207R00000X 31309 TN
Internal Medicine Physician 207R00000X 49518 KY
Pediatrics Physician 208000000X MD31309 TN

Addresses

Primary practice location

832 Savannah West CT
Suite F
Springfield, TN 37172

Mailing address

832 Savannah West CT
Suite F
Springfield, TN 37172-7387
Phone (615) 643-5008

Other identifiers 2

IdentifierTypeStateIssuer
3848225MedicaidTN
4108174OtherTNTENN CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040714001596 TN Practitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Emergency Medicine 7719966696 Reassigns benefits to 2 organizations
I20170322002052 KY Practitioner - Internal MedicinePractitioner - Pediatric MedicinePractitioner - Emergency Medicine 7719966696 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD31309TNMDEmergency Medicine Physician
31309TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Feb 10, 2017 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Aug 15, 2016 Accepting new patients
Northcrest Physician Services Inc Internal Medicine Past Accepting new patients
Millbrook Medical Center Pediatrics Past Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1100 Brookhaven Rd
Franklin, KY 42134
Phone (270) 586-3253

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

1625 Nashville St
Russellville, KY 42276
Phone (270) 726-4011

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

1260 University Ave
Sewanee, TN 37375
Phone (615) 598-5691

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1235124207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 SAVANNAH WEST CT",
            "address_2": "SUITE F",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371727387",
            "telephone_number": "615-643-5008",
            "fax_number": "615-643-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 SAVANNAH WEST CT",
            "address_2": "SUITE F",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "37172",
            "telephone_number": "615-483-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORENDO",
        "first_name": "RANDY",
        "middle_name": "ESTACION",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "MD31309",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD31309",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "49518",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "31309",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "49518",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD31309",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3848225",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENN CARE",
            "identifier": "4108174",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

Verify at the official NPI Registry.