Active NPI
Julie D Randolph, MS, OTR/L
- Pediatric Occupational Therapist
- Buford, GA
National Provider Identifier
1376742874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT004489
- Practice address
- 2140 Buford Hwy Ste 208
Buford, GA 30518-6124 - Phone
- (678) 482-4554
- Fax
- (678) 482-4576
- NPI assigned
- Jul 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT004489 | GA | Primary |
Addresses
Primary practice location
2140 Buford Hwy Ste 208
Buford, GA 30518-6124
Mailing address
2140 Buford Hwy Ste 208
Buford, GA 30518-6124
Phone (678) 482-4554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT004489 | GA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184284800000",
"number": "1376742874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2140 BUFORD HWY STE 208",
"city": "BUFORD",
"state": "GA",
"postal_code": "305186124",
"telephone_number": "678-482-4554",
"fax_number": "678-482-4576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 BUFORD HWY STE 208",
"city": "BUFORD",
"state": "GA",
"postal_code": "305186124",
"telephone_number": "678-482-4554",
"fax_number": "678-482-4576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDOLPH",
"first_name": "JULIE",
"middle_name": "D",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-13",
"last_updated": "2007-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "GA",
"license": "OT004489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.