Lilly J Randolph, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

159928 Issued in SC

Practice address

2719 Middleburg Dr
Suite 103
Columbia, SC 29204-2414

Phone

(803) 931-8337

Fax

(803) 931-8338

NPI assigned

May 11, 2006

Last updated

Oct 31, 2011By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Internal Medicine

Education

Washington University School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1467402446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PINCKNEY DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292094824",
            "telephone_number": "803-783-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 MIDDLEBURG DR",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042414",
            "telephone_number": "803-931-8337",
            "fax_number": "803-931-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "LILLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "159928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DBA PHYSICIANS MEDICAL GROUP OF SOUTH CAROLINA",
            "identifier": "1467402446",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Nathaniel Ramsey, MD
• Lexi Rand, FNP-C, PMHNP-BC
• Courtney Randall, APRN
• Danielle Randolph, RBT
• David Thomas Randolph, MD
• Myra Yolanda Randolph, RPH
• Samantha Randolph, MLT(ASCP)
• Sandra McKnight Randolph, NURSE PRACTITIONER
• Corey Ransom
• Maegan Pryren Ransome

• Internal Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.