Individual provider Active NPI

Randolph J Cordle, MD

  • Emergency Medicine Physician
  • Charlotte, NC
National Provider Identifier
1508896903
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2005-01146 Issued in NC
Practice address
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone
(704) 355-2171
Fax
(704) 355-5736
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 200501146 NC
Emergency Medicine Physician 207P00000X 01041556A IN
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 2005-01146 NC
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 2005-01146 NC
Diagnostic Ultrasound Physician 2085U0001X 2005-01146 NC
Emergency Medicine Physician 207P00000X 2005-01146 NC Primary

Addresses

Primary practice location

1000 Blythe Blvd
Charlotte, NC 28203-5812

Mailing address

PO Box 601372
Charlotte, NC 28260-1372
Phone (704) 355-2171

Other identifiers 3

IdentifierTypeStateIssuer
140JJOtherNCNCBCBS
N46005MedicaidSC
5900951MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rcordle744489@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200501146NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Feb 5, 2020 Accepting new patients
Carolinas Medical Center CurrentSince Feb 5, 2020 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Carolinas Medical Center Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Feb 5, 2020 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Oct 27, 2019 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Oct 27, 2019 Accepting new patients
Cumberland Pathology Associates, LLC Past Accepting new patients
Lancaster Hma Physician Management, LLC Past Accepting new patients
Cardiology Diagnostic Associates, LLC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

231 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 304-6400

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: rcordle537339@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1508896903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601372",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601372",
            "telephone_number": "704-355-2171",
            "fax_number": "704-355-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-2171",
            "fax_number": "704-355-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDLE",
        "first_name": "RANDOLPH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200501146",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01041556A",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "NC",
            "license": "2005-01146",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NC",
            "license": "2005-01146",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NC",
            "license": "2005-01146",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2005-01146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBCBS",
            "identifier": "140JJ",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N46005",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900951",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcordle744489@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1000 Blythe Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.