Individual provider Active NPI

Cassidy Ranique Randle, DO

  • Family Medicine Physician
  • Lexington, KY
National Provider Identifier
1437737301
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05930 Issued in KY
Practice address
245 Fountain CT Ste 120
Lexington, KY 40509-2792
Phone
(859) 218-2626
Fax
(859) 257-3322
NPI assigned
Mar 31, 2021
Last updated
Jan 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05930 KY Primary

Addresses

Primary practice location

245 Fountain CT Ste 120
Lexington, KY 40509-2792

Mailing address

2195 Harrodsburg Rd Ste 125
Lexington, KY 40504-3504
Phone (859) 257-4732

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240820003185 KY Practitioner - Family Practice 4587049358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

245 Fountain CT
Lexington, KY 40509-1888
Phone (859) 323-6021

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05930KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
University of Kentucky CurrentSince Aug 1, 2024 Accepting new patients
University of Kentucky PastSince Aug 4, 2024 Accepting new patients

Locations

2195 Harrodsburg Rd
Ste 125
Lexington, KY 40504
Phone (859) 257-4732

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

245 Fountain Ct
Lexington, KY 40509
Phone (859) 323-6021

245 Fountain Ct
Ste 120
Lexington, KY 40509
Phone (859) 218-2626

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1437737301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 HARRODSBURG RD STE 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043504",
            "telephone_number": "859-257-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 FOUNTAIN CT STE 120",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092792",
            "telephone_number": "859-218-2626",
            "fax_number": "859-257-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "CASSIDY",
        "middle_name": "RANIQUE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "05930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.