Amy Randolph, M.ED., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5025 Issued in NC

Practice address

35 Referendum Dr NE
Bolivia, NC 28422-7578

Phone

(910) 406-5100

NPI assigned

Dec 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Enrollment records 2

Specialty

Qualified Speech Language Pathologist

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

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.

• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Charlotte, NC
  • NPI 1285382440

  NC, Speech-Language Pathologist

  Medicare reassignment NPD
• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1902476633

  SC, Speech-Language Pathologist

  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Little River, SC
  • NPI 1366063000

  SC, Speech-Language Pathologist

  Medicare reassignment NPD
• Piedmont Therapy Services, Inc.

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1801963475
  NPD (past) Authorized official
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Speech-Language Pathologist

  NPD
• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Williamsburg, VA
  • NPI 1881366730

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1198886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1295910057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4974 KONA CT UNIT 2",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284617576",
            "telephone_number": "910-599-6994",
            "fax_number": "704-274-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 REFERENDUM DR NE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284227578",
            "telephone_number": "910-406-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "AMY",
        "credential": "M.ED., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-29",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "5639",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "5025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411551",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "11945",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE #",
            "identifier": "5025",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP PROVIDER #",
            "identifier": "7211429",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Kelly Poole, LCSW-A
• Brandi Posey, M.S. CCC-SLP
• James Rosser Powell, MD
• Ty Prentice, MA, NCC
• Laura Michele Quarino, NP
• Keith Christian Reschly, M.D.
• Rha Health Services Inc
• Riccobene & Associates I, DDS, P.a.
• Steven Eric Robbins, MD
• Nicole Amber Rose Cervantes, CNM

• All providers in Bolivia, NC
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.