NPIMap

Organization Active NPI

Roanoke Healthcare Authority

Doing business as Randolph Medical Center

  • Critical Access Hospital
  • Roanoke, AL
National Provider Identifier
1275591992
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H5601 Issued in AL
Legal business name
ROANOKE HEALTHCARE AUTHORITY
Doing business as
Randolph Medical Center
Practice address
59928 Highway 22
Roanoke, AL 36274-2410
Phone
(334) 863-4111
Fax
(334) 863-5427
NPI assigned
May 2, 2006
Last updated
Feb 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Authorized official

Name
Mr. Jon Dixon
Title
Administrator/Ceo
Phone
(334) 863-4111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X H5601 AL Primary

Addresses

Primary practice location

59928 Highway 22
Roanoke, AL 36274-2410

Mailing address

PO Box 670
Roanoke, AL 36274-0670
Phone (334) 863-4111

Other identifiers 3

IdentifierTypeStateIssuer
HOS1303HMedicaidAL
HOS0098HMedicaidAL
01045OtherALBCBS OF AL

Other names 1

  • RANDOLPH MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1275591992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "ROANOKE",
            "state": "AL",
            "postal_code": "362740670",
            "telephone_number": "334-863-4111",
            "fax_number": "334-863-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59928 HIGHWAY 22",
            "city": "ROANOKE",
            "state": "AL",
            "postal_code": "362742410",
            "telephone_number": "334-863-4111",
            "fax_number": "334-863-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE HEALTHCARE AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "334-863-4111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "AL",
            "license": "H5601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS1303H",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HOS0098H",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "01045",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RANDOLPH MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; 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.