DR. PATRICK F RANDOLPH (NPI# 1205894367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205894367 |
| Entity Type | Individual |
| Full Name | DR. PATRICK F RANDOLPH |
| Credential | MD |
| Practice Address |
1910 Nonconnah Blvd Suite 120 Memphis TN 38132-2113 |
| Mailing Address |
66 N Pauline St Suite 206 Memphis TN 38105-5105 |
| Practice Telephone | 9014482300 |
| Practice Fax Number | 9014486657 |
| Mailing Telephone | 9014487642 |
| Mailing Fax Number | 9014488015 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 39789 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 5440659 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013060946 | Patrick David Randolph | Psychologist | 5147 69th St Ste D, Lubbock, TX 79424-1646 | 2007-01-22 |
| 1912189622 | Patrick Randolph | Case Manager/Care Coordinator | 3223 E Broadway St, North Little Rock, AR 72114-6344 | 2007-12-04 |
| Street Address |
1910 NONCONNAH BLVD SUITE 120 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38132-2113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417933276 | Cynthia Denise Cross | Emergency Medicine | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2005-12-22 |
| 1265719496 | Tamara Devon Jones | Social Worker | 1910 Nonconnah Blvd, Suite #100, Memphis, TN 38132-2113 | 2011-11-16 |
| 1417244765 | Compass Laboratory Services LLC | Clinical Medical Laboratory | 1910 Nonconnah Blvd, 108, Memphis, TN 38132-2113 | 2011-07-07 |
| 1508090986 | Oana Maria Hendea | Audiologist | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2009-05-13 |
| 1649429119 | Dawna J. Willis | Nurse Practitioner | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2008-09-09 |
| 1538315304 | Samir Hasmukh Shah | Pediatrics | 1910 Nonconnah Blvd, Ste 120, Memphis, TN 38132-2113 | 2008-08-13 |
| 1710163373 | Martha Katheryn Ballard | Nurse Practitioner | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2008-01-14 |
| 1861673816 | Keith A. Collins | Nurse Anesthetist, Certified Registered | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2007-11-19 |
| 1851510978 | Mindy A Mullins | Nurse Anesthetist, Certified Registered | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2007-04-25 |
| 1275629396 | Sabrina Burns Kuster | Pediatrics | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2006-10-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386163707 | Casey Provo | Dietitian, Registered | 1689 Nonconnah Blvd., Memphis, TN 38132 | 2017-09-18 |
| 1164802195 | Cynthia Luaune Poole | Social Worker | 2606 Corporate Dr, Memphis, TN 38132 | 2015-06-04 |
| 1033375753 | Concentra Health Services, Inc. | Clinic/Center | 2831 Airways Blvd., Bldg. A, Suite 102, Memphis, TN 38132 | 2008-08-01 |
| 1063406676 | The Synergy Foundation, Inc. | Substance Abuse Rehabilitation Facility | 2305 Airport Interchange Avenue, Memphis, TN 38132 | 2005-09-09 |
| 1932488129 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 2831 Airways Blvd, Bldg A, Ste 102, Memphis, TN 38132 | 2011-08-05 |
| 1699181461 | Stacy Triplett | Counselor | 2305 Airport Interchange Ave, Memphis, TN 38132-1002 | 2014-07-01 |
| 1174852164 | Delois Roberson | Dentist | 2781 Airways Blvd, Memphis, TN 38132-1104 | 2009-12-22 |
| 1801380985 | Javier Jackson | Physical Therapist | 2781 Airways Blvd, Memphis, TN 38132-1104 | 2018-06-21 |
| 1326499252 | Joshua Mock | Physical Therapy Assistant | 2781 Airways Blvd, Memphis, TN 38132-1104 | 2016-06-22 |
| 1295112720 | Michelle Frulla | Physical Therapy Assistant | 2781 Airways Blvd, Memphis, TN 38132-1104 | 2015-05-05 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285015453 | Taylor Aglio | Pediatrics | 49 N Dunlap St # 131, Memphis, TN 38103-2802 | 2015-06-14 |
| 1326434465 | Amanda Green | Pediatrics | 262 N Danny Thomas Blvd # Ms 320, Memphis, TN 38105 | 2015-04-15 |
| 1366844490 | Gerard Joseph Billmeier Jr. | Pediatrics | 6465 Massey Lane, Memphis, TN 38120-3307 | 2014-09-19 |
| 1316348089 | James Levernier | Pediatrics | 4781 Park Ave, Memphis, TN 38117-5623 | 2014-09-11 |
| 1124454657 | Walter Thompson Hughes Jr. | Pediatrics | 854 River Park Dr, Memphis, TN 38103-0804 | 2013-09-16 |
| 1518301084 | Jennifer Lauren Miller | Pediatrics | 6401 Poplar Ave Ste 610, Memphis, TN 38119-4806 | 2013-04-26 |
| 1447506365 | Nickhill Hitesh Bhakta | Pediatrics | 262 Danny Thomas Way, Ms 721, Memphis, TN 38105 | 2012-07-29 |
| 1477845451 | Emilee Adelyn Dobish | Pediatrics | 850 Poplar Ave, Building 2, Memphis, TN 38103 | 2011-05-09 |
| 1366748055 | Silpa Peravali | Pediatrics | Lebonheur Childrens Hospital, 848 Adams Avenue, Memphis, TN 38103 | 2011-01-28 |
| 1275854259 | Melissa Ruth Hines | Pediatrics | 262 Danny Thomas Pl # Ms 734, Division of Pediatric Critical Care, Memphis, TN 38105-3678 | 2010-06-14 |
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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.