Kimberly T Randolph, ARNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

ARNP9318390 Issued in FL

Practice address

13047 W Linebaugh Ave Ste 102
Tampa, FL 33626-4487

Phone

(813) 475-6542

NPI assigned

Oct 2, 2013

Sex

Female

Sole proprietor

Yes

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 FL

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21490/brand/1/csg/1/fhir/r4
• Direct secure messaging: kimberly.randolph@213442497413124.direct.elationemr.com
• Direct secure messaging: kimberly.randolph.1@21490.direct.athenahealth.com

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.

• Randolph Diabetes and Wellness LLC

  • Adult Medicine Physician
  • Tampa, FL
  • NPI 1609378991

  Adult Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1457788671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13047 W LINEBAUGH AVE STE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264487",
            "telephone_number": "813-475-6542",
            "fax_number": "813-475-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13047 W LINEBAUGH AVE STE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264487",
            "telephone_number": "813-475-6542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6919 N Dale Mabry Hwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336143972",
            "country_code": "US",
            "telephone_number": "813-935-3221",
            "fax_number": "813-933-8149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "KIMBERLY",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "ARNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9318390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Richard Randall, M.D.
• Joseph C Randazzo Jr., PA-C
• Randall F Randazzo, M.D.
• Tara Marie Randis, M.D.
• Randolph Diabetes and Wellness LLC
• Tiffaney Sharee Randolph, ACNP-BC
• Victoria Elizabeth Randolph, PHARMD
• Rishi Rane, M.D.
• Judith Ranells, MD
• Ignacio Jose Ranero, M.D

• Adult Health Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.