Active NPI
Randy Williamson, MD
- Neurology with Special Qualifications in Child Neurology Physician
- Pensacola, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- ME146564
- Practice address
- 5153 N 9TH Ave
Pensacola, FL 32504-8785 - Phone
- (850) 416-1575
- Fax
- (850) 416-2160
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 43257 | TN | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | Q1773 | TX | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | E-6153 | AR | |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | ME146564 | FL | Primary |
Addresses
Primary practice location
5153 N 9TH Ave
Pensacola, FL 32504-8785
Mailing address
2102 Treasure Hills Blvd # 3.14406
Harlingen, TX 78550-8736
Phone (956) 296-1437
Other practice location 1
2102 Treasure Hills Blvd # 1.326
Harlingen, TX 78550
Phone (956) 296-1519
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2088965-04 | Medicaid | TX | |
| 8HQ341 | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
650 Clinic Dr
Mobile, AL 36688
PO Box
Suite 74645
Atlanta, GA 30374-6450
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME146564 | FL | MD | Neurology with Special Qualifications in Child Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacred Heart Health System, Inc. | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| University of Texas Rio Grande Valley | Past | Accepting new patients | |
| Pediatrix Medical Group of Tennessee, P.C. | Past | Accepting new patients |
Locations
807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600
4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691
8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700
5153 N 9th Ave
Pensacola, FL 32504
Phone (850) 416-1575
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1386658615
-
- Internal Medicine Physician
- Mobile, AL
- NPI 1720645468
-
- Ambulatory Family Planning Facility
- Pensacola, FL
- NPI 1962453308
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
-
- Children's Hospital
- Wilmington, DE
- NPI 1467505073
-
- Neonatal-Perinatal Medicine Physician
- Nashville, TN
- NPI 1497852107
-
- Physiological Laboratory
- Harlingen, TX
- NPI 1689330649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611792000000",
"number": "1326195298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2102 TREASURE HILLS BLVD # 3.14406",
"city": "HARLINGEN",
"state": "TX",
"postal_code": "785508736",
"telephone_number": "956-296-1437",
"fax_number": "956-296-6842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5153 N 9TH AVE",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325048785",
"telephone_number": "850-416-1575",
"fax_number": "850-416-2160"
}
],
"practiceLocations": [
{
"address_1": "2102 Treasure Hills Blvd # 1.326",
"address_purpose": "LOCATION",
"city": "Harlingen",
"state": "TX",
"postal_code": "78550",
"country_code": "US",
"telephone_number": "956-296-1519",
"fax_number": "956-296-1331",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "RANDY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2021-01-28",
"certification_date": "2021-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "TN",
"license": "43257",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "TX",
"license": "Q1773",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "AR",
"license": "E-6153",
"primary": false
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "FL",
"license": "ME146564",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2088965-04",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8HQ341",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.