Randy L Eccles, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101235804 Issued in VA

Practice address

3975 Virginia Mallory Dr
Chantilly, VA 20151-3974

Phone

(703) 272-5794

Fax

(703) 272-5650

NPI assigned

Dec 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1801032602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 VIRGINIA MALLORY DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513974",
            "telephone_number": "703-272-5794",
            "fax_number": "703-272-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 VIRGINIA MALLORY DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513974",
            "telephone_number": "703-272-5794",
            "fax_number": "703-272-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECCLES",
        "first_name": "RANDY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-29",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3573",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101235804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynamic Care Services LLC
• Dynamic Rehab and Spine Chantilly
• Amanda Renee Eastman, PHARMD
• Trish Suzanne Ebel, NP
• Annette Eccles, NCTMBW, LMT
• Katherine Eckl
• Eden Home Care LLC
• Eden Senior Care Services LLC
• Linda Egbeh
• Jill Eisner, APRN

• Internal Medicine Physician in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.