Khadijah Randolph, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN282234 Issued in PA

Practice address

5429 Germantown Ave
Philadelphia, PA 19144-2223

Phone

(215) 754-0240

NPI assigned

Jul 14, 2023

Last updated

Jul 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1528747714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 PINE ST APT 2E",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191436833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442223",
            "telephone_number": "215-754-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "KHADIJAH",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN282234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Randle
• Jennifer Rando, MT-BC
• Randolph Walters & Associates, LLC
• Frederick Randolph, MD
• Frederick William Randolph, MD
• Norman D. Randolph Jr., MD
• Sadia Randolph
• Toni Diahann Randolph
• Rands Helping Hands Home Care LLC
• Anjana Ranganathan, MD

• Licensed Practical Nurse in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Licensed Practical Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.