Randy Georgemiller, PH.D., P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071003110 Issued in IL

Legal business name

RANDY GEORGEMILLER, PH.D., P.C.

Practice address

4115 Columbia Rd
Suite 5-305
Martinez, GA 30907-0405

Phone

(847) 913-5175

NPI assigned

May 23, 2009

Organization subpart

No

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

Authorized official

Name

Randy Georgemiller, PH.D.

Title

President

Phone

(847) 913-5175

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1243036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1265667935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 COLUMBIA RD",
            "address_2": "SUITE 5-305",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070405",
            "telephone_number": "847-913-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 COLUMBIA RD",
            "address_2": "SUITE 5-305",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070405",
            "telephone_number": "847-913-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY GEORGEMILLER, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-23",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "GEORGEMILLER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-913-5175",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071003110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Martinez, GA
• Providers in Martinez, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.