Felicia R. Randolph, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301074153 Issued in MI

Practice address

2888 W Grand Blvd
Detroit, MI 48202-2612

Phone

(313) 875-5377

Fax

(313) 875-5727

NPI assigned

Jul 15, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Exclusive Physicians PLLC

  • Multi-Specialty Clinic/Center
  • Ferndale, MI
  • NPI 1811226749

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1710986450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 HAMLIN BLVD",
            "city": "INKSTER",
            "state": "MI",
            "postal_code": "481412206",
            "telephone_number": "313-561-5100",
            "fax_number": "313-561-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022612",
            "telephone_number": "313-875-5377",
            "fax_number": "313-875-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "FELICIA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301074153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4583949",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erian Randall
• Janeisha Randall
• Joi Randall
• Stacy Randall
• Michael Stephen Randazzo, M.D.
• Isabel A Randolph, MD
• Jazmine S Randolph
• La'Shunti Randolph, LLMSW
• Tonia Denise Randolph
• Lisa Marie Randon, M.D.

• Internal Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.