Walter Watson Randolph III, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

35071310R Issued in OH

Practice address

1417 Kaderly St NW
New Philadelphia, OH 44663-1242

Phone

(330) 602-5678

Fax

(330) 602-9604

NPI assigned

Jun 20, 2005

Sex

Male

Sole proprietor

No

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 OH

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

Specialty

Obstetrics/Gynecology

Education

University of Toledo College of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis Hospital Hospital, Zanesville, OH, CCN 360039
• Union Hospital Hospital, Dover, OH, CCN 360010
• Aultman Hospital Hospital, Canton, OH, CCN 360084

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Genesis Medical Group LLC

  • General Practice Physician
  • Zanesville, OH
  • NPI 1063663433
  Medicare reassignment Care Compare group NPD
• Genesis Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Coshocton, OH
  • NPI 1144022187
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation
• Genesis Healthcare System

  • Community/Retail Pharmacy
  • Zanesville, OH
  • NPI 1184435414

  Hospital

  Care Compare affiliation
• Genesis Healthcare System

  • Community/Retail Pharmacy
  • Zanesville, OH
  • NPI 1477150951

  Hospital

  Care Compare affiliation
• Genesis Healthcare System

  • General Acute Care Hospital
  • Zanesville, OH
  • NPI 1598868655
  Care Compare affiliation
• Genesis Healthcare System

  • Community/Retail Pharmacy
  • Coshocton, OH
  • NPI 1710839436

  Hospital

  Care Compare affiliation
• The Union Hospital Association

  • Rural Acute Care Hospital
  • Dover, OH
  • NPI 1871606921
  Care Compare affiliation

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1992700520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 KADERLY ST NW",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "446631242",
            "telephone_number": "330-602-5678",
            "fax_number": "330-602-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 KADERLY ST NW",
            "city": "NEW PHILADELPHIA",
            "state": "OH",
            "postal_code": "446631242",
            "telephone_number": "330-602-5678",
            "fax_number": "330-602-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "WALTER",
        "middle_name": "WATSON",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35071310R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2127157",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alva Althea Pugh, LPC
• Puretone Hearing Services, Inc.
• Quaker Digital Academy
• Paula A Quillin, L.M.T.
• Farrah Raines, COTA/L
• Bailey R Reed
• Brandalyn Regula, MOT, OTR/L
• Calliannie Dixon Reidenbach, DMD
• Rennicker Chiropractic LLC
• Brandon Lee Rennicker, D.C.

• Obstetrics & Gynecology Physician in New Philadelphia, OH
• Providers in New Philadelphia, OH by specialty
• Obstetrics & Gynecology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.