NPIMap

Organization Active NPI

Randolph Specialty Group Practice

  • Internal Medicine Physician
  • Asheboro, NC
National Provider Identifier
1891756946
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RANDOLPH SPECIALTY GROUP PRACTICE
Practice address
237 N Fayetteville St Ste a
Asheboro, NC 27203-5573
Phone
(336) 625-3248
Fax
(336) 625-6629
NPI assigned
Mar 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Authorized official

Name
Mr. Robert Scott Clauser
Title
Executive Director
Phone
(336) 625-2333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

237 N Fayetteville St Ste a
Asheboro, NC 27203-5573

Mailing address

PO Box 5418
Asheboro, NC 27204-5418
Phone (336) 625-2333

Other identifiers 2

IdentifierTypeStateIssuer
890248RMedicaidNC
0248ROtherNCBCBS GROUP NUMBER

Other names 1

  • Randolph Health Internal Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Randolph Health Family Practice5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1891756946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5418",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272045418",
            "telephone_number": "336-625-2333",
            "fax_number": "336-625-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 N FAYETTEVILLE ST STE A",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035573",
            "telephone_number": "336-625-3248",
            "fax_number": "336-625-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH SPECIALTY GROUP PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "CLAUSER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-625-2333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890248R",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0248R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randolph Health Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Asheboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.