NPIMap

Individual provider Active NPI

Randall Thomas Eldridge, DPM

  • Podiatrist
  • Hickory, NC
National Provider Identifier
1497195341
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
627 Issued in NC
Practice address
1501 Tate Blvd SE Ste 203
Hickory, NC 28602-1385
Phone
(828) 304-0400
Fax
(828) 304-0142
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC006463 PA
Podiatrist 213E00000X 627 NC Primary

Addresses

Primary practice location

1501 Tate Blvd SE Ste 203
Hickory, NC 28602-1385

Mailing address

1501 Tate Blvd SE Ste 203
Hickory, NC 28602-1385
Phone (828) 304-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160623001450 NC Practitioner - Podiatry 2062703937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eldridge Podiatry PAGroup PAC ID 6002209467, 5 clinicians

Practice addresses (Care Compare)

1501 Tate Blvd SE
Suite 203
Hickory, NC 28602-1385
Phone (828) 304-0440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
68.21
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue153
Removal of skin lesions1-10
Removal of nail tissue969
Removal or shaving of skin growth258
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
627NCMDPodiatrist
SC006463PAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eldridge Podiatry PA Podiatrist CurrentSince Jan 1, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1501 Tate Blvd SE
Ste 203
Hickory, NC 28602
Phone (828) 304-0400

303 S Green St
Ste 102
Morganton, NC 28655
Phone (828) 304-0400

Organizations & group practices 2

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 6

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1497195341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 TATE BLVD SE STE 203",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021385",
            "telephone_number": "828-304-0400",
            "fax_number": "828-304-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TATE BLVD SE STE 203",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286021385",
            "telephone_number": "828-304-0400",
            "fax_number": "828-304-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "RANDALL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC006463",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.