Kamala Joy Randolph, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD28882 Issued in OR

Practice address

1427 NW Flanders St Ste a
Portland, OR 97209-2646

Phone

(503) 972-0235

Fax

(971) 216-4964

NPI assigned

May 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

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

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.

• Clinicops, LLC

  • Family Medicine Physician
  • Portland, OR
  • NPI 1275821266
  Medicare reassignment NPD
• Clinicops LLC

  • Internal Medicine Physician
  • Florence, OR
  • NPI 1497251268
  NPD (past)

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1801002548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2459 SE TUALATIN VALLEY HWY # 413",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971237919",
            "telephone_number": "503-972-0235",
            "fax_number": "971-216-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 NW FLANDERS ST STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092646",
            "telephone_number": "503-972-0235",
            "fax_number": "971-216-4964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Garden Rd",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939405373",
            "country_code": "US",
            "telephone_number": "831-372-5841",
            "fax_number": "831-372-4820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 Garden Rd",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939405373",
            "country_code": "US",
            "telephone_number": "831-372-5841",
            "fax_number": "831-372-4820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "KAMALA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00048113",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00048113",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD28882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8482374",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500648424",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geraldine Randles, LMT
• Jamie Lee Randles, MD
• Scott Randol
• Christopher Alan Randolph, ND
• Connie Rae Randolph, LPN
• Nicole Randt, OTR/L
• Randy Allen Castle DMD, PC
• Sarah Carmen Rane, MSW
• Meagan Rochelle Ranes, LMT
• Ziphrianne Cina Raneses

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

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