NPIMap

Organization Active NPI

Randolph Specialty Group Practice

  • Otolaryngology Physician
  • Asheboro, NC
National Provider Identifier
1619126992
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
RANDOLPH SPECIALTY GROUP PRACTICE
Practice address
124 N Park St
Asheboro, NC 27203-5440
Phone
(336) 625-1007
Fax
(336) 625-0350
NPI assigned
Sep 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Authorized official

Name
Mr. Robert Scott Clauser
Title
Executive Director
Phone
(336) 625-2333

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0007X NC

Addresses

Primary practice location

124 N Park St
Asheboro, NC 27203-5440

Mailing address

PO Box 5418
Asheboro, NC 27204-5418
Phone (336) 625-2333

Other identifiers 1

IdentifierTypeStateIssuer
5950054MedicaidNC

Other names 1

  • Randolph Health Ear, Nose & Throat Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1619126992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5418",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272045418",
            "telephone_number": "336-625-2333",
            "fax_number": "336-625-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 N PARK ST",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035440",
            "telephone_number": "336-625-1007",
            "fax_number": "336-625-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH SPECIALTY GROUP PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "CLAUSER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-625-2333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950054",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randolph Health Ear, Nose & Throat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Asheboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.