Blake William Randles, D.C.

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209031892 Issued in IL

Practice address

20733 N Broad St
Carlinville, IL 62626-3710

Phone

(217) 854-3141

NPI assigned

Jul 19, 2010

Last updated

Apr 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/carlin-6115abf3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alvarado Healthcare LLC

  • Chiropractor
  • Highland, IL
  • NPI 1326553835
  Medicare reassignment NPD
• Carlinville Area Hospital Association

  dba Carlinville Area Hospital

  • Critical Access Hospital
  • Carlinville, IL
  • NPI 1053425124
  Medicare reassignment NPD
• Carlinville Area Hospital Association

  dba Carlinville Area Hospital

  • Critical Access Hospital
  • Carlinville, IL
  • NPI 1932275641
  Medicare reassignment NPD
• Hillsboro Area Hospital, Inc.

  • Hospitalist Physician
  • Hillsboro, IL
  • NPI 1821078213
  Medicare reassignment NPD
• Lebanon Healthcare LLC

  dba Alvarado Healthcare

  • Chiropractor
  • Lebanon, IL
  • NPI 1427892090
  Medicare reassignment NPD
• Hillsboro Area Hospital, Inc.

  • Critical Access Hospital
  • Hillsboro, IL
  • NPI 1194705210
  Medicare reassignment
• HSHS Holy Family Hospital Inc

  • General Acute Care Hospital
  • Greenville, IL
  • NPI 1205850690
  Medicare reassignment
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F

  dba HSHS St. Joseph's Hospital -Highland

  • Critical Access Hospital
  • Highland, IL
  • NPI 1447352323
  Medicare reassignment
• Carlinville Area Hospital Association

  • Rural Health Clinic/Center
  • Gillespie, IL
  • NPI 1295518769
  NPD
• Carlinville Area Hospital Association

  dba Virden Family Health Care

  • Rural Health Clinic/Center
  • Virden, IL
  • NPI 1447691571
  NPD
• Hillsboro Area Hospital, Inc.

  dba Hillsboro Area Hospital Primary Care Clinic

  • Rural Health Clinic/Center
  • Hillsboro, IL
  • NPI 1811774771
  NPD
• Carlinville Area Hospital Association

  dba Carlinville Area Hospital Association - Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Carlinville, IL
  • NPI 1275609109
  NPD (past)

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1679886675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 WASHINGTON ST",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491925",
            "telephone_number": "186-544-5206",
            "fax_number": "618-654-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20733 N BROAD ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626263710",
            "telephone_number": "217-854-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 W Saint Louis St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "IL",
            "postal_code": "622541559",
            "country_code": "US",
            "telephone_number": "618-654-4520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1210 Washington St",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "IL",
            "postal_code": "622491925",
            "country_code": "US",
            "telephone_number": "618-654-4520",
            "fax_number": "618-654-1063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDLES",
        "first_name": "BLAKE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-19",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209031892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patterson House, Inc. (Carlinville Estates)
• Gary James Pellizzaro, D.M.D.
• Patricia A. Pope, LMFT
• Rachel B Pranger, PA
• Shona Jo Quick, FNP
• Jane B Reichmann, P.T.
• Michaela Nichole Reichmann, RDH, PHRDH
• Jennifer Lynn Richards, RN
• Marissa Lee Robinson, RD LD
• Rodney L Bailey, DMD, PC

• Gerontology Nurse Practitioner in Carlinville, IL
• Providers in Carlinville, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.