Randall Frederick O'Brien, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

43249 Issued in GA

Practice address

2003 Alice St
Suite a
Waycross, GA 31501-6209

Phone

(912) 287-1130

Fax

(912) 287-9114

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Orthopaedic Specialists of South Georgia

  • Orthopaedic Surgery Physician
  • Waycross, GA
  • NPI 1912019308
  NPD (past)
• Waycross Orthopaedics, P.C.

  • Specialist
  • Waycross, GA
  • NPI 1679520753
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1346236155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2267",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315022267",
            "telephone_number": "912-283-9309",
            "fax_number": "912-287-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 ALICE ST",
            "address_2": "SUITE A",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016209",
            "telephone_number": "912-287-1130",
            "fax_number": "912-287-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "RANDALL",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "43249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "200040070",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00764772C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manel Dinesh Nayak, M.D.
• Jules M Nehmetallah, MD
• Neurological Associates of the South, LLC
• Stacie Norman, LAPC
• Deirdre K O'Brien, NP-C
• Aleta Deonne O'Quinn
• Greta D O'Steen, RN
• OB-GYN Associates of Waycross, PLLC
• Okefenokee Anesthesia Company LLC
• Okefenokee EMS Inc.

• Specialist in Waycross, GA
• Providers in Waycross, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.