Individual provider Active NPI

Randolph Jett McMurtry, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Lone Tree, CO
National Provider Identifier
1710109681
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
19021 Issued in CO
Practice address
10101 Ridge Gate Parkway
Sky Ridge Medical Center Dept of Pathology
Lone Tree, CO 80124
Phone
(720) 225-1261
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 19021 CO Primary

Addresses

Primary practice location

10101 Ridge Gate Parkway
Sky Ridge Medical Center Dept of Pathology
Lone Tree, CO 80124

Mailing address

270 Ash Street
Denver, CO 80220
Phone (303) 333-0210

Other identifiers 1

IdentifierTypeStateIssuer
01190214MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Pathology Consultants PC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Organizations & group practices 1

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710109681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 ASH STREET",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80220",
            "telephone_number": "303-333-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 RIDGE GATE PARKWAY",
            "address_2": "SKY RIDGE MEDICAL CENTER DEPT OF PATHOLOGY",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "80124",
            "telephone_number": "720-225-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMURTRY",
        "first_name": "RANDOLPH",
        "middle_name": "JETT",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CO",
            "license": "19021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01190214",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.