Randys House of Medicine

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

RANDYS HOUSE OF MEDICINE

Practice address

305 Front St
Taylorsville, MS 39168-0818

Phone

(601) 785-6812

Fax

(601) 785-4993

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Diane Wyatt

Title

Owner

Phone

(601) 785-6812

Specialties & licenses 2

Addresses

Other identifiers 3

Tax ID family

Randy'S House of Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Randy'S House of Medicine

  • Durable Medical Equipment & Medical Supplies
  • Taylorsville, MS
  • NPI 1780714386
  NPD tax ID

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1689708133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 818",
            "city": "TAYLORSVILLE",
            "state": "MS",
            "postal_code": "391680818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 FRONT ST",
            "city": "TAYLORSVILLE",
            "state": "MS",
            "postal_code": "391680818",
            "telephone_number": "601-785-6812",
            "fax_number": "601-785-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDYS HOUSE OF MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-785-6812"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "01523",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2515382",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040383",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030655",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mississippi State Department of Health
• Stephen Grant Nichols, MPT
• Off Main Street Medical PLLC
• Sheuna Posey, LCMHT
• Randy'S House of Medicine
• Carolyn Ann Schrader, N.P.
• Hailey Scott, PT, DPT
• Jory Scott, ATC, LAT
• Mark Waylon Scruggs, FNP-C
• Sharon L Scruggs, FNP-BC

• Community/Retail Pharmacy in Taylorsville, MS
• Providers in Taylorsville, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.