Teresa N Randolph, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A003603 Issued in AR

Practice address

220 Stage Coach Dr
Pineville, MO 64856

Phone

(479) 790-8505

Fax

(479) 587-1366

NPI assigned

Jul 7, 2006

Last updated

Apr 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Teresa Nicole May Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: trandolph220723@directc.mercy.net

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.

• Intermountain Medical Group Grand Junction, LLC

  • Orthopaedic Surgery Physician
  • Grand Junction, CO
  • NPI 1356765556
  Medicare reassignment NPD
• Intermountain Medical Group Grand Junction, LLC

  dba Craig Neurosurgery Outreach Clinic

  • Medical Specialty Clinic/Center
  • Craig, CO
  • NPI 1245843481
  NPD
• Intermountain Medical Group Grand Junction, LLC

  dba DME - Wellington Neurosurgery Clinic

  • Durable Medical Equipment & Medical Supplies
  • Grand Junction, CO
  • NPI 1609737618
  NPD
• Heart and Vascular Care, P. C.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Joplin, MO
  • NPI 1427160514
  NPD (past)
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  NPD (past)
• Integris Bass Baptist Health Center

  dba Integris Health Medical Group Medford

  • Rural Health Clinic/Center
  • Medford, OK
  • NPI 1730180894
  NPD (past)
• Integris Rural Health Inc

  dba Urgent Care Plus

  • Family Medicine Physician
  • Enid, OK
  • NPI 1467454991
  NPD (past)
• Urgent Care Associates PLLC

  • Urgent Care Clinic/Center
  • Enid, OK
  • NPI 1871593442
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1326071176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 PARKWAY CIR",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626362",
            "telephone_number": "479-587-1700",
            "fax_number": "479-587-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 STAGE COACH DR",
            "city": "PINEVILLE",
            "state": "MO",
            "postal_code": "64856",
            "telephone_number": "479-790-8505",
            "fax_number": "479-587-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "TERESA",
        "middle_name": "N",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "87036",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "45975",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A003603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "0087036",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200048950A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "MAY",
            "middle_name": "NICOLE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gary David Neymeyer, OD
• Tony Hieu Nguyen, PHARM D
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Tamon Berber Paige, M.D.
• Jill Rogers
• Sgoh Acquisition, Inc.
• Norman Alan Smith, DC
• State Line Chiropractic Clinic LLC
• Wal-Mart Stores East LP (Vision Center 30-5261)

• Family Nurse Practitioner in Pineville, MO
• Providers in Pineville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.