John Franklin Randolph, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

G48108 Issued in CA

Practice address

410 E Parkcenter Cir N
San Bernardino, CA 92408-2869

Phone

(909) 501-9932

NPI assigned

Jul 7, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrandolph609970@direct.llu.edu

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.

• Canyon Springs Medical Group, Inc.

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1073669404
  Medicare reassignment NPD

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1750389482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7779",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923750779",
            "telephone_number": "951-205-0937",
            "fax_number": "909-580-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E PARKCENTER CIR N",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082869",
            "telephone_number": "909-501-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "JOHN",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "G48108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randall W. Halliday, D.D.S., Inc.
• Tehura Randall
• Arnel Randle
• Dina Randle
• Cynthia Randles Duran
• Elias Antoni Rangel
• Justine Rangel
• Marlene Rangel
• Gianni Rankins
• Maricelle Ranola, RDN, MPH

• Geriatric Medicine (Family Medicine) Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Geriatric Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.