DR. JACQUETTA TAISHA RANDALL (NPI# 1588982466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588982466 |
| Entity Type | Individual |
| Full Name | DR. JACQUETTA TAISHA RANDALL |
| Credential | M.D. |
| Practice Address |
451 Ruin Creek Rd Suite 101 Henderson NC 27536-2878 |
| Practice Telephone | 2524929565 |
| Mailing Telephone | 2524929565 |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2012-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 2012-01956 | NC | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | A111970 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
451 RUIN CREEK RD SUITE 101 |
| City | HENDERSON |
| State | NC |
| Zip Code | 27536-2878 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235194671 | Cornelius F Cathcart | Pediatrics | 451 Ruin Creek Rd, Suite 101, Henderson, NC 27536-2878 | 2006-04-19 |
| 1790221612 | Interventional Pain Center, Pllc | Anesthesiology | 451 Ruin Creek Rd, Suite 103, Henderson, NC 27536-2878 | 2017-01-17 |
| 1235530825 | Lovika Horton | Nurse Practitioner | 451 Ruin Creek Rd, Henderson, NC 27536-2878 | 2014-09-15 |
| 1740613207 | Mary Leann Michelle Cathcart | Nurse Practitioner | 451 Ruin Creek Rd, Suite 101, Henderson, NC 27536-2878 | 2013-08-19 |
| 1750635470 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 451 Ruin Creek Rd, Suite 202, Henderson, NC 27536-5965 | 2012-11-02 |
| 1881904084 | Tina Gupta Dds Pa II | Clinic/Center | 451 Ruin Creek Rd, Suite 201, Henderson, NC 27536-2878 | 2010-10-21 |
| 1881926517 | Britney Kasey Sanders | Physician Assistant | 451 Ruin Creek Rd, Suite 101, Henderson, NC 27536-2878 | 2010-02-05 |
| 1518148519 | Allison Anne Hayhurst | Physician Assistant | 451 Ruin Creek Rd, Suite 101, Henderson, NC 27536-2878 | 2007-11-19 |
| 1992902266 | Mark Fordham | Prosthetist | 451 Ruin Creek Rd, Ste. 102, Henderson, NC 27536-2878 | 2007-06-29 |
| 1083824163 | James Louis Schmitt | Pediatrics | 451 Ruin Creek Rd, Suite 101 Henderson Pediatrics Center, Henderson, NC 27536 | 2007-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952940926 | Lane and Associates Xxxvi Dds Pa | Dentist | 900 South Garnett St., Henderson, NC 27536 | 2019-12-23 |
| 1487012076 | Melissa Burroughs | Registered Nurse | 943-h W. Andrews Avenue, Henderson, NC 27536 | 2016-02-10 |
| 1578949269 | Growth Recovery Opportunity & Wellness | Community/Behavioral Health | 804 South Garnett St, Henderson, NC 27536 | 2015-08-04 |
| 1003290297 | Saintpaulhealthcarept, Inc. | Home Health | 839 E Montgomery St, Henderson, NC 27536 | 2015-07-17 |
| 1518369859 | Kristina Thornton | Pharmacist | 200 North Cooper Road, Henderson, NC 27536 | 2014-09-18 |
| 1306285135 | Green Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 429 Sunnyview Road, Henderson, NC 27536 | 2013-06-14 |
| 1760820278 | Innovative Health Services | In Home Supportive Care | 1758 Parham Street, Henderson, NC 27536 | 2013-06-06 |
| 1578900015 | Frances Veronica Finamore | Counselor | 710 Parham Street, Henderson, NC 27536 | 2013-05-23 |
| 1952530834 | Sucessful Achievements Program Incorporated | Driver | 133 Us 1 A, Norlina, NC 27536 | 2009-07-13 |
| 1407096100 | Recovery Response Center | Psychiatric Hospital | 300 Parkview Drive, Henderson, NC 27536 | 2009-02-20 |
| Find all providers in zip 27536 | ||||
| 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 |
|---|---|---|---|---|
| 1669028106 | Harold Zilberman, Md, Chartered | Pediatrics | 880 Seven Hills Dr Ste 100, Henderson, NV 89052-4372 | 2019-08-12 |
| 1740747542 | Payton Cerda | Pediatrics | 2510 W Horizon Ridge Pkwy Ste 130, Henderson, NV 89052-1600 | 2019-02-27 |
| 1922494764 | Jennifer Romo Santistevan | Pediatrics | 1505 Wigwam Pkwy Ste 230, Henderson, NV 89074 | 2015-04-08 |
| 1679852891 | Jung Y. Hahr | Pediatrics | 969 Wagner Valley St, Henderson, NV 89052-5064 | 2011-08-04 |
| 1174755276 | Placida Martinez | Pediatrics | 247 Clemson St, Henderson, NV 89074-5484 | 2009-08-22 |
| 1306029830 | Mdfamily Medical Group | Pediatrics | 152 Zeb Robinson Rd, Henderson, NC 27537-3577 | 2007-12-06 |
| 1346374238 | Susan R Fernandez PC | Pediatrics | 2621 W Horizon Ridge Pkwy Ste 100, Henderson, NV 89052-2895 | 2007-03-15 |
| 1750422481 | Jagannath S. Surpure, M.d.p.c. | Pediatrics | 1600 W Sunset Rd, Suite A, Henderson, NV 89014-2654 | 2007-02-08 |
| 1184774093 | James Allen Wayne Jr. | Pediatrics | 451 Ruin Creek Rd Ste 101, Henderson, NC 27536-5920 | 2007-01-11 |
| 1982763108 | Hesham Sirsy Md Ltd | Pediatrics | 10950 S Eastern Ave, #100, Henderson, NV 89052-4970 | 2006-12-06 |
| Find all providers in HENDERSON | ||||
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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.