Blake Randolph, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A156287 Issued in IA

Practice address

604 West St
Reinbeck, IA 50669-1353

Phone

(319) 575-0180

NPI assigned

Aug 20, 2019

Last updated

Aug 21, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Regional Medical CenterGroup PAC ID 7315858529, 170 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Regional Medical Center Hospital, Fort Dodge, IA, CCN 160016
• Stewart Memorial Community Hospital Hospital, Lake City, IA, CCN 161350

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandolph694709@direct.unitypoint.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Trinity Regional Medical Center

  dba UnityPoint Clinic

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  Medicare reassignment Care Compare group NPD
• Allen Memorial Hospital Corporation

  dba Allen Hospital

  • Women's Health Nurse Practitioner
  • Waterloo, IA
  • NPI 1891772927
  Medicare reassignment NPD
• Iowa Physicians Clinic Medical Foundation

  dba UnityPoint Clinic

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274
  Medicare reassignment
• Allen Memorial Hospital Corporation

  dba Allen Hospital

  • Emergency Medicine Physician
  • Waterloo, IA
  • NPI 1346292521

  Nurse Practitioner

  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Stewart Memorial Community Hospital

  • Critical Access Hospital
  • Lake City, IA
  • NPI 1063497188
  Care Compare affiliation
• Trinity Regional Medical Center

  dba UnityPoint Health Trinity Regional Medical Center

  • General Acute Care Hospital
  • Fort Dodge, IA
  • NPI 1487759858
  Care Compare affiliation

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1295382786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 WEST ST",
            "city": "REINBECK",
            "state": "IA",
            "postal_code": "506691353",
            "telephone_number": "319-575-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 WEST ST",
            "city": "REINBECK",
            "state": "IA",
            "postal_code": "506691353",
            "telephone_number": "319-575-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "BLAKE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A156287",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A156287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sigita Jankunas, D.D.S.
• Douglas Hein Koele, DDS
• Brett Morton Medhus, D.C.
• Parkview Manor, Inc.
• Phil's Pharmacy, LLC (Phil's Pharmacy)
• Reinbeck Family Dental (Douglas H Koele DDS)
• Reinbeck Firemen Inc
• Reinbeck Pharmacy Inc (Reinbeck Pharmacy)
• Seen & Heard Psychiatry, PLLC
• Gregory Alan Selenke, D.O.

• Nurse Practitioner in Reinbeck, IA
• Providers in Reinbeck, IA by specialty
• Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.