Randolph Philip Rountree, M.D., PSY.D.

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

C0076 Issued in NM

Practice address

1505 S Don Roser Dr Ste a
Las Cruces, NM 88011-4596

Phone

(719) 238-9111

NPI assigned

Dec 15, 2011

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

Other names 1

• Dr. Randolph Philip Rountree Professional name

Medicare fee-for-service enrollment

Enrolled in CO, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1891064150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2005",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808662005",
            "telephone_number": "719-238-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 S DON ROSER DR STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114596",
            "telephone_number": "719-238-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUNTREE",
        "first_name": "RANDOLPH",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "M.D., PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-15",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "3689",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "C0076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDOLPH",
            "last_name": "ROUNTREE",
            "middle_name": "PHILIP",
            "prefix": "DR.",
            "credential": "MD, PSYD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Richard Bush Ross, M.D.
• Carissa Shalini Rosten, DO
• Heather Roth
• Madison Roth
• Rachel Rothengass
• Michael J Rourke, LISW
• Route 44 Medical Transport
• Michael Rowe
• Morgan Rowland
• Ron Rowlett, PT

• Prescribing (Medical) Psychologist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Prescribing (Medical) Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.