Kelly Shrout Randolph, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3007554 Issued in KY

Practice address

1101 Veterans Dr
Lexington, KY 40502-2235

Phone

(859) 233-4511

NPI assigned

Oct 16, 2012

Last updated

Nov 12, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

State licenses

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1396098364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1038 RAINTREE DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753003",
            "telephone_number": "859-358-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 VETERANS DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022235",
            "telephone_number": "859-233-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "KELLY",
        "middle_name": "SHROUT",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus Eddie Randall, MD
• Nancy Tidwell Randall
• Sallie Elizabeth Randall, PA-C
• Cassidy Ranique Randle, DO
• Daylyn Sunshine Randolph
• Christian Raney, BSW
• Lori Ann Rangel, PA
• Dinesh Ranjan, MD
• Ratnabali Ranjan, M.D.
• Jennifer Rankin, LPCC

• Family Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.