Organization Active NPI

Taylor Randich, OD, PLLC

  • Optometrist
  • Harrisburg, NC
National Provider Identifier
1528923562
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TAYLOR RANDICH, OD, PLLC
Practice address
4039 Harris Square Dr
Harrisburg, NC 28075-5104
Phone
(704) 223-2595
NPI assigned
Dec 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Taylor Randich, ODNPI 1710478532
Title
President
Phone
(704) 223-2595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

4039 Harris Square Dr
Harrisburg, NC 28075-5104

Mailing address

2116 Prairie Rd
Concord, NC 28027-0062

Other practice location 1

3230 Prosperity Church Rd Ste 103
Charlotte, NC 28269-0033
Phone (704) 548-9888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260303001430 NC Part B Supplier - Clinic/Group Practice 8022590793 Receives reassigned benefits from 1 practitioner
Practice locations: Harrisburg, NC

National Provider Directory

National Provider Directory

Locations

4055 Harris Square Dr
Ste 4039
Harrisburg, NC 28075
Phone (704) 223-2595

4039 Harris Square Dr
Harrisburg, NC 28075
Phone (704) 223-2595

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1528923562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 PRAIRIE RD",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280270062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 HARRIS SQUARE DR",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280755104",
            "telephone_number": "704-223-2595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3230 Prosperity Church Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282690033",
            "country_code": "US",
            "telephone_number": "704-548-9888",
            "fax_number": "704-548-0077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TAYLOR RANDICH, OD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-22",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "RANDICH",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-223-2595",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.