Beverly Michelle Randolph, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

J10001461 Issued in DE

Practice address

810 S Broom St
Suite B
Wilmington, DE 19805-4245

Phone

(302) 652-1181

NPI assigned

Nov 8, 2005

Last updated

Aug 20, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Beverly Michelle Bradley Former name

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1265413280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S BROOM ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054245",
            "telephone_number": "302-652-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S BROOM ST",
            "address_2": "SUITE B",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054245",
            "telephone_number": "302-652-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "BEVERLY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J10001461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "BRADLEY",
            "middle_name": "MICHELLE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terry L Ramsey, LCSW
• Shahryar Tariq Rana, MD
• Allison Renee Randall, LCSW
• Mia Randall
• Alora Rando, PHD
• Eric Randolph
• Seema Rani, MD
• Katie Raniszewski
• Jennifer A Ranton, M.D.
• Rajiv Rao, PHARM.D.

• Physical Therapist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Physical Therapist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.