Wendell Lewis Randall, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

36016 Issued in NC

Practice address

956 N Main St
Mount Airy, NC 27030-3747

Phone

(336) 648-8550

Fax

(336) 648-8551

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Bethany Medical Center

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1952404188

  Anatomic Pathology & Clinical Pathology

  NPD (past)
• Pathology and Nuclear Medicine of Pittsburgh

  • Anatomic Pathology & Clinical Pathology Physician
  • MC Kees Rocks, PA
  • NPI 1770538787
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1902856065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 N MAIN ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270303747",
            "telephone_number": "336-648-8550",
            "fax_number": "336-648-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 N MAIN ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270303747",
            "telephone_number": "336-648-8550",
            "fax_number": "336-648-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "WENDELL",
        "middle_name": "LEWIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "36016",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "36016",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "VVF492B944",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "70121",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89070121",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA MEDICAL BOARD MEDICAL LICENSE",
            "identifier": "36016",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Leigh Puckett-Lawson, FNP-C
• Ritchie D Puckett, LCAS-A
• Stephanie Puckett, LPCA
• Kevin Brent Pyles, PT
• Renee Denise Ramey
• Leanna Gentry Reed, LCSWA
• Rebecca Reed, FNP-C
• Joanna Refvem, L.P.C.
• Danielle Reitzel, C.F.-SLP
• Carl Ray Rhoden, MD

• Anatomic Pathology & Clinical Pathology Physician in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Anatomic Pathology & Clinical Pathology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.