Individual provider Active NPI

Randi Bliss Kotal-Lee, NP

  • Gerontology Nurse Practitioner
  • Seneca, SC
National Provider Identifier
1932441565
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
18472 Issued in SC
Practice address
390 Keowee School Rd
Seneca, SC 29672-6743
Phone
(864) 885-7129
Fax
(864) 882-7240
NPI assigned
Mar 21, 2013
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN218154 GA
Gerontology Nurse Practitioner 363LG0600X 18472 SC Primary

Addresses

Primary practice location

390 Keowee School Rd
Seneca, SC 29672-6743

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 1

IdentifierTypeStateIssuer
NP2705MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rlee128821@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140117001547 SC Practitioner - Nurse Practitioner 0648408757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, shared by 5 NPIs, 2,467 clinicians

Practice addresses (Care Compare)

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

301 Memorial Dr
Suite F
Seneca, SC 29672-9445
Phone (864) 885-7758

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18472SCMDRegistered Nurse
RN218154GAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Oct 1, 2014 Accepting new patients
Prisma Health University Medical Group CurrentSince Nov 8, 2016 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
GHS Partners in Health, Inc. CurrentSince Oct 1, 2014 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

10110 Clemson Blvd
Seneca, SC 29678
Phone (864) 482-0500

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

390 Keowee School Rd
Seneca, SC 29672
Phone (864) 882-8940

772 N Townville St
Seneca, SC 29678
Phone (864) 886-9300

Interoperability endpoints

  • Direct secure messaging: rlee128821@direct.ghs.myhfn.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1932441565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 KEOWEE SCHOOL RD",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296726743",
            "telephone_number": "864-885-7129",
            "fax_number": "864-882-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTAL-LEE",
        "first_name": "RANDI",
        "middle_name": "BLISS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN218154",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "18472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2705",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlee128821@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rlee128821@direct.ghs.myhfn.org",
            "address_1": "390 Keowee School Rd",
            "city": "Seneca",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296726743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.