Mark B Randolph, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L8483 Issued in TX

Practice address

1920 Corporate Dr
Suite 208
San Marcos, TX 78666-6077

Phone

(512) 878-6330

Fax

(512) 878-6941

NPI assigned

Feb 8, 2006

Last updated

Aug 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HDJEAD/Endpoint/HDJEAD

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.

• Bernard T Swift Jr., DO

  • Occupational Medicine Physician
  • San Antonio, TX
  • NPI 1497722235
  Medicare reassignment
• Mark Randolph MD PA

  dba Randolph Family Medicine

  • Primary Care Clinic/Center
  • San Marcos, TX
  • NPI 1891859476
  Authorized official Same address or phone
• Cobb Allergy Clinic of San Marcos

  dba Allergy and Family Medicine

  • Allergy & Immunology Physician
  • San Marcos, TX
  • NPI 1164680781
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1982677209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1621",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786671621",
            "telephone_number": "512-878-6330",
            "fax_number": "512-878-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 CORPORATE DR",
            "address_2": "SUITE 208",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666077",
            "telephone_number": "512-878-6330",
            "fax_number": "512-878-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "MARK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC NUMBER",
            "identifier": "L8483",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Renee Ramirez, LVN
• Ramos Family Eye Care, PLLC (Texas State Optical-San Marcos)
• Robert Joseph Ramos, O.D.
• Sarah Katherine Ramos
• Vivian Kearney Ramsay, ORT/L
• Lynn F Raska, SLP
• Mayuri Rataul
• Ray Family Therapy, PLLC
• Jacqueline Ray, LVN
• RB Chiro, Inc. (Well Family Chiropractic)

• Family Medicine Physician in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.