KERRY RANDOLPH (NPI# 1063531390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063531390 |
| Entity Type | Individual |
| Full Name | KERRY RANDOLPH |
| Credential | M.D. |
| Practice Address |
3525 S National Ave Ste 101 Springfield MO 65807-7310 |
| Mailing Address |
Po Box 4046 Springfield MO 65808-4046 |
| Practice Telephone | 4172695711 |
| Mailing Telephone | 4172696262 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | R9C05 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANTHEM BLUECROSS | 27694 | 01 |
| Street Address |
3525 S NATIONAL AVE STE 101 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-7310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891790408 | Larry K Chase | Internal Medicine | 3525 S National Ave, Ste 101, Springfield, MO 65807-7310 | 2005-06-20 |
| 1922452457 | Stefanie Hawkins | Pharmacist | 3525 S National Ave, Suite 207, Springfield, MO 65807-7310 | 2016-04-21 |
| 1992100333 | Clint Carroz | Specialist/Technologist | 3525 S National Ave, Springfield, MO 65807-7310 | 2014-10-28 |
| 1255749511 | Kristin L Torgerson | Nurse Practitioner | 3525 S National Ave, #101, Springfield, MO 65807-7315 | 2014-07-30 |
| 1922430065 | Latoya M. Compton | Nurse Practitioner | 3525 S National Ave, #207, Springfield, MO 65807-7310 | 2013-07-31 |
| 1568794477 | Steven D Atwood, Md Facp | Internal Medicine | 3525 S National Ave, Suite 206, Springfield, MO 65807-7310 | 2010-02-02 |
| 1003980228 | Regional Services | Family Medicine | 3525 S National Ave, #307, Springfield, MO 65807-7310 | 2006-11-20 |
| 1700950912 | Regional Services | Family Medicine | 3525 S National Ave, Suite 202, Springfield, MO 65807-7310 | 2006-11-20 |
| 1174693709 | Regional Services | Clinic/Center | 3525 S National Ave, #101, Springfield, MO 65807-7310 | 2006-11-09 |
| 1174693444 | Lester E. Cox Medical Centers | Clinic/Center | 3525 S National Ave, #101, Springfield, MO 65807-7310 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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|---|---|---|---|---|
| 1639675077 | Anand Kanjolia, M.d. LLC | Internal Medicine | 222 Carew St Fl 4, Springfield, MA 01104-4109 | 2018-04-04 |
| 1376068817 | Personal Primary Care and Weight Management, LLC | Internal Medicine | 299 Carew St Ste 234, Springfield, MA 01104-2368 | 2017-08-05 |
| 1184145682 | Basma Al-bast | Internal Medicine | 701 N 1st St Ste 434, Springfield, IL 62702-3757 | 2017-07-05 |
| 1689124604 | John Duff | Internal Medicine | 2909 S Camber Ave, Springfield, MO 65809-3547 | 2016-10-13 |
| 1669834941 | Siddhi Joshi | Internal Medicine | 5501 Backlick Rd Ste 105, Springfield, VA 22151-3940 | 2016-03-24 |
| 1265898936 | Mohammad Rahimuddin | Internal Medicine | 2556 Snyder Domer Rd, Springfield, OH 45502-8161 | 2016-01-11 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1033589304 | Hshs Medical Group Inc | Internal Medicine | 3215 Executive Park Dr, Springfield, IL 62703-4514 | 2015-09-30 |
| 1679992895 | Ahlam Elbadri | Internal Medicine | 2115 S Fremont Ave Ste 2300, Springfield, MO 65804-2233 | 2014-04-15 |
| 1528487543 | Barbara Vinci | Internal Medicine | 2443 Troy Rd, Springfield, OH 45504-4233 | 2014-04-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.