Tyler Randolph, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104557681 Issued in VA

Practice address

520 Lew Dewitt Blvd Ste 402
Waynesboro, VA 22980-1644

Phone

(540) 943-3638

NPI assigned

Dec 15, 2023

Sex

Male

Sole proprietor

Yes

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

Enrolled in VA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Healing Path Chiropractic LLC

  • Chiropractor
  • Waynesboro, VA
  • NPI 1003681842
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1255109534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 JASPERS LN",
            "city": "STUARTS DRAFT",
            "state": "VA",
            "postal_code": "244772849",
            "telephone_number": "540-836-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 LEW DEWITT BLVD STE 402",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229801644",
            "telephone_number": "540-943-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PT Plus of Augusta, LLC
• R. Jonas Collins, DMD, PC
• Paula Elaine Radulski, ATC, RN
• Nellie Ann Ramirez, LSATP,ADC
• Ramt & Acm, Inc
• Angel Katrina Ray, DDS, MS
• Rector & Visitors of the University of Virginia
• Jordan Poole Reed
• Megan Reed, NCC
• Stacy Lynn Reeder, STACY L. REEDER DVM

• Chiropractor in Waynesboro, VA
• Providers in Waynesboro, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.