Active NPI
Randy MC Collum, PT
- Pediatric Physical Therapist
- Martinsville, VA
National Provider Identifier
1871001198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 2305002268
- Practice address
- 101 Cleveland Ave
Martinsville, VA 24112-3700 - Phone
- (276) 233-6752
- NPI assigned
- Jan 22, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 2305002268 | VA | Primary |
Addresses
Primary practice location
101 Cleveland Ave
Martinsville, VA 24112-3700
Mailing address
101 Cleveland Ave Ste D
Martinsville, VA 24112-3700
Phone (276) 233-6752
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2305002268 | Other | VA | STATE OF VIRGINIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305002268 | VA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516579200000",
"number": "1871001198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CLEVELAND AVE STE D",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241123700",
"telephone_number": "276-233-6752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CLEVELAND AVE",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241123700",
"telephone_number": "276-233-6752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MC COLLUM",
"first_name": "RANDY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-22",
"last_updated": "2018-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "VA",
"license": "2305002268",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF VIRGINIA",
"identifier": "2305002268",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martinsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.