Individual provider Active NPI

Randolph L. Royster Jr., MD

  • Therapeutic Radiology Physician
  • Clyde, NC
National Provider Identifier
1972553790
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Therapeutic Radiology PhysicianTaxonomy code 2085R0203X
License
19717 Issued in NC
Practice address
600 Hospital Dr
Suite 10
Clyde, NC 28721-8046
Phone
(828) 452-2320
Fax
(828) 456-4707
NPI assigned
May 11, 2006
Last updated
Oct 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Therapeutic Radiology Physician 2085R0203X 19717 NC Primary

Addresses

Primary practice location

600 Hospital Dr
Suite 10
Clyde, NC 28721-8046

Mailing address

2234 Colonial Blvd
Fort Myers, FL 33907-1412
Phone (239) 931-7342

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19717NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1972553790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HOSPITAL DR",
            "address_2": "SUITE 10",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218046",
            "telephone_number": "828-452-2320",
            "fax_number": "828-456-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYSTER",
        "first_name": "RANDOLPH",
        "middle_name": "L.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NC",
            "license": "19717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.