Individual provider Active NPI

Bridget Randolph, ARNP

  • Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1972805133
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN230003 Issued in GA
Practice address
1267 Highway 54 W Ste 2200
Fayetteville, GA 30214-2110
Phone
(770) 716-0051
NPI assigned
Nov 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN230003 GA
Family Nurse Practitioner 363LF0000X 83618 OK
Nurse Practitioner 363L00000X RN230003 GA Primary

Addresses

Primary practice location

1267 Highway 54 W Ste 2200
Fayetteville, GA 30214-2110

Mailing address

PO Box 30589
Midwest City, OK 73140-3589
Phone (405) 769-3301

Other practice location 1

5185 Old National Hwy
Atlanta, GA 30349-3244
Phone (404) 763-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130909000081 GA Practitioner - Nurse Practitioner 1850567017 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians
Grady Memorial Hospital CorporationGroup PAC ID 7517032998, 365 clinicians

Practice addresses (Care Compare)

1267 Hwy 54 W
Suite 2200
Fayetteville, GA 30214
Phone (770) 716-0051

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3050
Phone (404) 616-8880

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079
  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as group
Quality
87.56
Promoting interoperability
100
Improvement activities
40
Cost
75.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN230003GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Jul 14, 2020 Accepting new patients
Piedmont Cardiology of Atlanta, LLC CurrentSince Oct 1, 2021 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Jul 14, 2020 Accepting new patients
Prime Direct Care CurrentSince Oct 24, 2021 Accepting new patients
City of Hope Medical Group of Georgia LLC CurrentSince Feb 22, 2016 Accepting new patients
Georgia Pain Physicians PC Nurse Practitioner Past Accepting new patients
Mercy Access LLC Past Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

9070 Peridot Pkwy
Stockbridge, GA 30281
Phone (678) 907-0663

62742 Collections Ctr Dr
Chicago, IL 60693

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1290297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1972805133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30589",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731403589",
            "telephone_number": "405-769-3301",
            "fax_number": "405-769-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W STE 2200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142110",
            "telephone_number": "770-716-0051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5185 Old National Hwy",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303493244",
            "country_code": "US",
            "telephone_number": "404-763-9300",
            "fax_number": "404-763-9304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "BRIDGET",
        "name_prefix": "Miss",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-21",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN230003",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "83618",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN230003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.