Richard C Randolph MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10006 Issued in MS

Legal business name

RICHARD C RANDOLPH MD PA

Practice address

348 Crossgates Blvd
Suite 2200
Brandon, MS 39042-2616

Phone

(601) 825-2466

Fax

(601) 824-8137

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard C Randolph, M.D.NPI 1275632325

Title

President

Phone

(601) 825-2466

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Richard C Randolph, M.D.

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1275632325
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313366400000",
    "number": "1679672745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 CROSSGATES BLVD",
            "address_2": "SUITE 2200",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422616",
            "telephone_number": "601-825-2466",
            "fax_number": "601-824-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 CROSSGATES BLVD",
            "address_2": "SUITE 2200",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422616",
            "telephone_number": "601-825-2466",
            "fax_number": "601-824-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD C RANDOLPH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-08-15",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-825-2466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "10006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03920519",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MEDICARE",
            "identifier": "DG3008",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Resolve to Restore Counseling Services
• Mollie Reynolds
• Shelby Reynolds, LCSW
• Toni Reynolds
• Wanda L Rice-Smith
• Richard W Pharr MD PA
• Andrea Richards, SLP
• Laura Mars Richardson, LPC, LMFT
• Corneisha J Richmond, SLP
• Lindsay J Rigby

• Family Medicine Physician in Brandon, MS
• Providers in Brandon, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.