Individual provider Active NPI

Randall C Hildestad

  • Physical Therapist
  • Madison, AL
National Provider Identifier
1659257541
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH12427 Issued in AL
Practice address
33 Hughes Rd
Madison, AL 35758-2238
Phone
(256) 319-9327
Fax
(256) 319-9328
NPI assigned
Aug 14, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH12427 AL Primary

Addresses

Primary practice location

33 Hughes Rd
Madison, AL 35758-2238

Mailing address

42465 Highway 195
Haleyville, AL 35565-7052
Phone (256) 350-1764

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251006001263 AL Practitioner - Physical Therapist in Private Practice 9335645548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of South Alabama College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

251 Johnston St SE
Suite 300
Decatur, AL 35601-2515

42465 Hwy 195
Haleyville, AL 35565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH12427ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed Orthopaedic Specialists, PC CurrentSince Aug 6, 2025 Accepting new patients
Sportsmed Orthopaedic Specialists CurrentSince Aug 6, 2025 Accepting new patients

Locations

4715 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 319-8500

33 Hughes Rd
Madison, AL 35758
Phone (256) 319-9327

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1659257541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42465 HIGHWAY 195",
            "city": "HALEYVILLE",
            "state": "AL",
            "postal_code": "355657052",
            "telephone_number": "256-350-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 HUGHES RD",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582238",
            "telephone_number": "256-319-9327",
            "fax_number": "256-319-9328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDESTAD",
        "first_name": "RANDALL",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH12427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.