Randolph Medical Practices PA
NPI 1144320052ActiveOrganization· Family Medicine· Lake City, FL
Family Medicine in Lake City, Florida, registered in NPPES in September 2006. The authorized official on file is Tommy Lavaughn Randolph, Md. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1144320052 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 22, 2006 |
| Last updated in NPPES | Oct 31, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | ME46235 | FL |
| Pediatrics | 208000000X | ME51982 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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