Randall Scott Keith, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39630 Issued in NC

Practice address

104 Ararat Longhill Rd
Pilot Mountain, NC 27041-8113

Phone

(336) 786-7966

Fax

(336) 786-1601

NPI assigned

Jun 16, 2005

Last updated

Jun 14, 2012By the provider in NPPES

Sex

Male

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 NC

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

Family Practice

Education

Wake Forest University School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, King, NC, CCN 347330
• Northern Regional Hospital Hospital, Mount Airy, NC, CCN 340003
• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: randall.keith.1@15683.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holly Springs Family Practice

  • Family Medicine Physician
  • Pilot Mountain, NC
  • NPI 1346353869
  NPD (past) Authorized official
• Pioneer Health Services of Stokes County, Inc.

  dba Pioneer Family Medical of Westfield

  • Clinic/Center
  • Westfield, NC
  • NPI 1033534912
  NPD (past)

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

• Capital Care Resources, LLC

  dba CenterWell Home Health

  • Home Health Agency
  • King, NC
  • NPI 1396775045
  Care Compare affiliation
• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Northern Hospital of Surry County

  dba North Hospital of Surry County

  • General Acute Care Hospital
  • Mount Airy, NC
  • NPI 1366449282
  Care Compare affiliation

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1477558542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ARARAT LONG HILL RD",
            "city": "PILOT MOUNTAIN",
            "state": "NC",
            "postal_code": "270418113",
            "telephone_number": "336-786-7966",
            "fax_number": "336-786-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ARARAT LONGHILL RD",
            "city": "PILOT MOUNTAIN",
            "state": "NC",
            "postal_code": "270418113",
            "telephone_number": "336-786-7966",
            "fax_number": "336-786-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "RANDALL",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "39630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Ann Holland, RPH
• Holly Springs Family Practice
• Hyke Family Eyecare OD PLLC
• Stephanie Cheryl Johnson, M.A., LPC
• Samantha Smith Joyce, FNP
• Kent N. Tucker,D.D.S.,P.a.
• Kidscan Therapy Services
• Sheri Ann Kretzschmar, R.N.
• Kimberly Scarlet May-Sepulveda
• Selena McHone, RT(MR)

• Family Medicine Physician in Pilot Mountain, NC
• Providers in Pilot Mountain, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.