Individual provider Active NPI

Tiffany Patrice Randolph, M.D.

  • Cardiovascular Disease Physician
  • Greensboro, NC
National Provider Identifier
1861636300
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2012-01170 Issued in NC
Practice address
3200 Northline Ave Ste 250
Greensboro, NC 27408-7619
Phone
(336) 273-7900
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2012-01170 NC Primary

Addresses

Primary practice location

3200 Northline Ave Ste 250
Greensboro, NC 27408-7619

Mailing address

872 Vandalia Dr
Cary, NC 27519-1890

Other practice location 1

DUMC Box 3182
Duke University Internal Medicine Program
Durham, NC 27710
Phone (919) 684-3165

Other names 1

  • Dr. Tiffany Patrice Callaway Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address trandolph232223@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20150825002953 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1052627874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Harvard Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1126 N Church St
Suite 300
Greensboro, NC 27401-1037
Phone (336) 938-0800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012-01170NCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation CurrentSince Jul 30, 2023 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Past Accepting new patients

Locations

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

3200 Northline Ave
Ste 250
Greensboro, NC 27408
Phone (336) 273-7900

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

3518 Drawbridge Pkwy
Ste 220
Greensboro, NC 27410
Phone (336) 890-3020

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

Interoperability endpoints

  • Direct secure messaging: trandolph232223@direct.conehealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1861636300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 VANDALIA DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275191890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 NORTHLINE AVE STE 250",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087619",
            "telephone_number": "336-273-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "DUMC Box 3182",
            "address_2": "Duke University Internal Medicine Program",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "27710",
            "country_code": "US",
            "telephone_number": "919-684-3165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "TIFFANY",
        "middle_name": "PATRICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2012-01170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trandolph232223@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "cone health direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 Northline Ave Ste 250",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274087619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "CALLAWAY",
            "middle_name": "PATRICE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.