MR. DERRICK AARON RANDOLPH (NPI# 1760882690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760882690 |
| Entity Type | Individual |
| Full Name | MR. DERRICK AARON RANDOLPH |
| Credential | RN |
| Practice Address |
1207 7th St S.e. Decatur/morgan Hospital - Parkway Campus Decatur GA 35601 |
| Mailing Address |
2030 Cleveland Ave S.w Decatur AL 35601 |
| Practice Telephone | 2563412000 |
| Mailing Telephone | 2563533501 |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2015-01-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 1-090988 | AL | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-090988 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 1-090988 | AL | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902305725 | Derrick Randolph | Case Manager/Care Coordinator | 463 6th St, Toledo, OH 43605-1701 | 2018-02-07 |
| Street Address |
1207 7TH ST S.E. DECATUR/MORGAN HOSPITAL - PARKWAY CAMPUS |
| City | DECATUR |
| State | GA |
| Zip Code | 35601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| 1336408830 | Mishanta Reyes | Obstetrics & Gynecology | 1215 7th St Se Fl 2, Decatur, AL 35601 | 2012-05-04 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729965 | Jamie Mclemore | Nurse Practitioner | 17619 Hwy 58 North, Decatur, TN 37322-3732 | 2020-10-30 |
| 1790383776 | Angela Tope Adeleke | Nurse Practitioner | 3185 Georgian Woods Cir, Decatur, GA 30034-5105 | 2020-10-13 |
| 1417564147 | Jigna Patel | Nurse Practitioner | 1963 Don Juan Ln, Decatur, GA 30032-4218 | 2020-09-27 |
| 1659983856 | Emilie Carsell Mathias | Nurse Practitioner | 2208 N Crossing Way, Decatur, GA 30033-4175 | 2020-08-19 |
| 1275151078 | Tiffanie Marshall Mcguire | Nurse Practitioner | 2042 Beltline Rd Sw Ste B101, Decatur, AL 35601-5571 | 2020-07-08 |
| 1922623610 | Anastasiya A Drogoul | Nurse Practitioner | 2675 N Decatur Rd Ste 404, Decatur, GA 30033-6133 | 2020-06-09 |
| 1174156244 | Anne Marie Strickland | Nurse Practitioner | 3109 Vicksburg Pl Sw, Decatur, AL 35603-3107 | 2020-02-18 |
| 1174161822 | Allison Leanne Hall | Nurse Practitioner | 304 W Hay St Ste 312, Decatur, IL 62526-4170 | 2019-12-12 |
| 1396387866 | Elizabeth Nichole Mathews | Nurse Practitioner | 2301 S Fm 51 Ste 100, Decatur, TX 76234-3864 | 2019-10-16 |
| 1861040479 | Oladunni Funmi Faminu | Nurse Practitioner | 2701 N Decatur Rd # 2400, Decatur, GA 30033-5918 | 2019-08-27 |
| Find all providers in DECATUR | ||||
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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.