DR. JOHN JAMES RANDOLPH (NPI# 1700881463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700881463 |
Entity Type | Individual |
Full Name | DR. JOHN JAMES RANDOLPH |
Credential | PH.D. |
Practice Address |
20 W Park St Ste 215 Lebanon NH 03766-1378 |
Mailing Address |
20 W Park St Suite 215 Lebanon NH 03766-1378 |
Practice Telephone | 6034486779 |
Practice Fax Number | 6036530246 |
Mailing Telephone | 6036530330 |
Mailing Fax Number | 6036530330 |
Enumeration Date | 2005-06-17 |
Last Update Date | 2014-03-04 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | 1027 | NH | Behavioral Health & Social Service Providers |
N | 103T00000X | Psychologist | 1027 | NH | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NH | ANTHEM BLUE CROSS BLUE SH | 06Y007347NH01 | 01 |
VT | BLUE CROSS BLUE SHIELD | 00068596 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871656900 | John T Randolph | Chiropractor | 10223 Broadway St Ste C, Pearland, TX 77584-7881 | 2006-12-19 |
1750481214 | John L Randolph | Psychologist | 43 Starbird St., Malden, MA 02148-2835 | 2006-09-25 |
1750389482 | John Franklin Randolph | Family Medicine | 410 E Parkcenter Cir N, San Bernardino, CA 92408-2869 | 2005-07-07 |
1689677882 | John Randolph | Family Medicine | 105 Liberty Blvd, Liberty, SC 29657-1641 | 2005-05-23 |
1427286491 | John Taylor Randolph | Counselor | 605 W Oxford Ave, Enid, OK 73701-1208 | 2009-06-29 |
1619122264 | John S Randolph | Dentist | 11121 Health Park Blvd, Suite 200, Naples, FL 34110-5739 | 2008-11-24 |
1225296577 | John Whitney Randolph | Emergency Medicine | 6 Glen Cove Dr, Rockport, ME 04856-4240 | 2008-05-22 |
1164621330 | John Carlton Randolph | Ophthalmology | 250 Avenue K Sw, Suite 200, Winter Haven, FL 33880-3914 | 2007-07-17 |
1174610943 | John F Randolph Jr. | Obstetrics & Gynecology | 475 Market Place, Bldg One, Ann Arbor, MI 48108-1649 | 2006-10-05 |
1629065636 | John D Randolph | Surgery | 4050 W Memorial Rd Fl 3, Oklahoma City, OK 73120-8382 | 2005-10-04 |
Street Address |
20 W PARK ST STE 215 |
City | LEBANON |
State | NH |
Zip Code | 03766-1378 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235336017 | Marjorie Ann Hudgens | Social Worker | 20 W Park St, Counseling Center of Lebanon, Lebanon, NH 03766-1378 | 2007-06-27 |
1871719971 | Faith Catlin | Social Worker | 20 W Park St, Suite 312, Lebanon, NH 03766-1378 | 2007-04-17 |
1730227372 | Jon Gerald Aldrich | Social Worker | 20 W Park St, Suite 214, Lebanon, NH 03766-1378 | 2007-02-04 |
1730225509 | Michelle Linda Belk | Counselor | 20 W Park St, Suite 213, Lebanon, NH 03766-1378 | 2007-01-29 |
1497806889 | Kimberly Knowlton-young | Social Worker | 20 W Park St, Lebanon, NH 03766-1378 | 2007-01-15 |
1134219678 | Joan Kundin Doubleday | Counselor | 20 W Park St, Lebanon, NH 03766-1378 | 2006-10-13 |
1013927870 | Joseph Peter Saginor | Psychologist | 20 W Park St, Suite 209, Lebanon, NH 03766-1378 | 2006-08-08 |
1255372405 | Charles Edward Lindner | Counselor | 20 W Park St, Suite 214, Lebanon, NH 03766-1378 | 2006-06-09 |
1033161807 | Susan G Kahn | Counselor | 20 W Park St, Suite 413, Lebanon, NH 03766-1378 | 2006-05-17 |
1174588800 | Jennifer Jill Fischer | Psychologist | 20 W Park St, Ste 213, Lebanon, NH 03766 | 2006-04-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033580345 | Leah E Abrahamsen | Social Worker | 85 Mechanic Street Suite 3b-1, Dartmouth Hitchcock - Psychiatry, Lebanon, NH 03766 | 2015-10-13 |
1871982801 | Steps Opioid Addiction Treatment | Clinic/Center | 1 Glen Road, Suite 216, Lebanon, NH 03766 | 2015-01-14 |
1811282288 | Lisa Golden Morse | Occupational Therapist | 23 Mahon St, Lebanon, NH 03766 | 2011-06-14 |
1750607131 | Timothy Joseph Lin | Orthopaedic Surgery | 1 Medical Center Drive Orthopaedics, Lebanon, NH 03766 | 2010-04-11 |
1457673857 | Melanie A Baker | Dental Hygienist | One Court Street, Suite 270, Lebanon, NH 03766 | 2010-02-26 |
1568613073 | Peter Keith Isquith | Clinical Neuropsychologist | 367 Route 120 Unit B1, Hanover Road Professional Center, Lebanon, NH 03766 | 2008-10-02 |
1235317512 | Leslie Sudak | Speech-Language Pathologist | 10 Mascoma St, Lebanon, NH 03766 | 2008-02-08 |
1891973269 | Dc Whitfield | Nurse Practitioner | 20 W Park St Ste 418, Lebanon, NH 03766 | 2008-02-07 |
1588879951 | Charles R Meyers | Acupuncturist | 2 Whipple Place, Lebanon, NH 03766 | 2007-05-11 |
1285859686 | Thomas A Johnston | Dentist | 206 Heater Road, Lebanon, NH 03766 | 2007-04-13 |
Find all providers in zip 03766 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568613073 | Peter Keith Isquith | Clinical Neuropsychologist | 367 Route 120 Unit B1, Hanover Road Professional Center, Lebanon, NH 03766 | 2008-10-02 |
1821611401 | Cierra Keith | Clinical Neuropsychologist | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2020-05-18 |
1699142794 | Catherine Lorraine Williams | Clinical Neuropsychologist | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2015-08-25 |
1891863106 | Robert Mark Roth | Clinical Neuropsychologist | 1 Medical Center Drive, Lebanon, NH 03756-0001 | 2006-12-04 |
1407924723 | Andrew J Saykin | Clinical Neuropsychologist | 1 Medical Center Drive, Lebanon, NH 03756-0001 | 2006-12-04 |
1104994680 | Heather Ann Wishart | Clinical Neuropsychologist | 1 Medical Center Drive, Lebanon, NH 03756-0001 | 2006-12-01 |
1730131707 | Laura A Flashman | Clinical Neuropsychologist | 1 Medical Center Dr, Dept of Psychiatry Hb7750, Lebanon, NH 03756-1000 | 2006-05-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831500511 | Matthew Holcomb | Clinical Neuropsychologist | 335 Bog Rd, Enfield, NH 03748-4103 | 2014-05-15 |
1407133226 | Ekaterina Tolstikova | Clinical Neuropsychologist | 150 Myrtle Street, Manchester, NH 03104-6025 | 2011-11-08 |
1841244522 | William Thomas Mautz | Clinical Neuropsychologist | 20 Ladd St, 4th Floor, Portsmouth, NH 03801-4089 | 2006-05-19 |
1730162843 | William J. Jamieson | Clinical Neuropsychologist | 61 North St, Manchester, NH 03104-3029 | 2005-11-22 |
1326035734 | James Beauregard | Clinical Neuropsychologist | 138 Webster St, Manchester, NH 03104-2512 | 2005-09-30 |
1003816992 | Douglas F. Watt | Clinical Neuropsychologist | 24 Charlotte Ave, Nashua, NH 03064-1551 | 2005-07-21 |
1467801811 | Jessica Y. Rhee | Clinical Neuropsychologist | 40 Buttrick Rd, Londonderry, NH 03053 | 2016-06-07 |
1164730420 | Susan R Mcgurk | Clinical Neuropsychologist | 105 Pleasant St, Dartmouth Psychiatric Research Center, Main Building, Concord, NH 03301-3852 | 2010-09-21 |
1104059237 | Orion Diagnostics Incorporated | Clinical Neuropsychologist | 138 Elm Street, Newport, NH 03773-0025 | 2009-08-24 |
1073745899 | Meagan Etchells Lentz | Clinical Neuropsychologist | 138 Webster St, Manchester, NH 03104-2512 | 2009-08-12 |
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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.