Holly Randolph, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119005003 Issued in VA

Practice address

721 Pepper Ave
Richmond, VA 23226-2704

Phone

(804) 477-4908

NPI assigned

Apr 15, 2020

Reactivated

Dec 3, 2021

Sex

Female

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 SC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehabilitation Services of South Carolina, LLCGroup PAC ID 3971639998, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Fox Rehabilitation Services of South Carolina, LLC

  • Physical Therapist
  • Lexington, SC
  • NPI 1902133689

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1295354686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 PEPPER AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262704",
            "telephone_number": "804-477-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 PEPPER AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262704",
            "telephone_number": "804-477-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "HOLLY",
        "name_prefix": "Dr.",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "deactivation_date": "2021-10-26",
        "reactivation_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noor Rana, MD
• Christian Ross Randazzo, MD
• Abigail Randolph
• Carla Randolph, LCSW, CSAC
• David M Randolph II, MD
• Jessica Dionne Randolph, MD
• Krystal L. Randolph, M.S., ATC, VATL
• Sherwood Alfonso Randolph Jr., LCSW
• Aparna Ranjan, M.D.
• Mary M Ransom, MD

• Occupational Therapist in Richmond, VA
• Providers in Richmond, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.