Individual provider Active NPI

Randy Williamson, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Pensacola, FL
National Provider Identifier
1326195298
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
ME146564 Issued in FL
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

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2088965-04MedicaidTX
8HQ341OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210201001265 FL Practitioner - NeurologyPractitioner - Pediatric Medicine 2062563935 Reassigns benefits to 1 organization
I20260324000463 AL Practitioner - NeurologyPractitioner - Pediatric Medicine 2062563935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pediatric Medicine
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

LicenseStateTypeSpecialty
ME146564FLMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Aug 11, 2025 Accepting new patients
The Nemours Foundation CurrentSince Aug 11, 2025 Accepting new patients
University of Texas Rio Grande Valley Past Accepting new patients
Pediatrix Medical Group of Tennessee, P.C. PastSince Feb 1, 2017 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.

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

Verify at the official NPI Registry.