Randolph W Heath, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2170 Issued in FL

Practice address

120 Health Park Blvd Ste 1
St Augustine, FL 32086-5798

Phone

(904) 823-3401

Fax

(904) 829-8649

NPI assigned

Feb 20, 2007

Sex

Male

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 FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Epn Urgent Care LLC

  • Emergency Medicine Physician
  • Naples, FL
  • NPI 1275624579
  NPD

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1306981378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HEALTH PARK BLVD STE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865798",
            "telephone_number": "904-823-3401",
            "fax_number": "904-829-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEALTH PARK BLVD STE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865798",
            "telephone_number": "904-823-3401",
            "fax_number": "904-829-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH",
        "first_name": "RANDOLPH",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Health Park Podiatric Foot and Ankle Clinic, Inc
• Healthcare Properties of St Augustine Inc (Ponce de Leon Care Center or The Ponce Therapy Care Center)
• Healthy Minds Psychological Services, LLC
• Heart Center of Saint Augustine, PA
• Kirsten Heath, PT, DPT
• Hebbler Rehabilitation, Inc.
• George Paul Hebbler III, PT, DPT
• Lora Danielle Hebbler, OT/L
• Matthew Alexander Heckroth, MD
• Elizabeth Riley Heijkoop

• Medical Physician Assistant in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.