DR. ROYAL RANDOLPH JR. (NPI# 1881725414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881725414 |
| Entity Type | Individual |
| Full Name | DR. ROYAL RANDOLPH JR. |
| Credential | M.D. |
| Practice Address |
2200 Main St Suite 517 Wailuku HI 96793-1654 |
| Mailing Address |
Po Box 1441 Wailuku HI 96793-6441 |
| Practice Telephone | 8082449677 |
| Practice Fax Number | 8082424805 |
| Mailing Telephone | 8082449677 |
| Mailing Fax Number | 8082424805 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-10-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
MD 4946 | HI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | 017302-01 | 05 |
| Street Address |
2200 MAIN ST SUITE 517 |
| City | WAILUKU |
| State | HI |
| Zip Code | 96793-1654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245286780 | Royal Randolph, Jr., M.d., M.p.h., LLC | Psychiatry & Neurology | 2200 Main St, Suite 517, Wailuku, HI 96793-1681 | 2006-05-26 |
| 1164064754 | Karin M Rohr | Counselor | 2200 Main St, Wailuku, HI 96793-1681 | 2019-10-15 |
| 1740665488 | Bayada Home Care | Home Health | 2200 Main St, Suite 650, Wailuku, HI 96793-1681 | 2015-07-23 |
| 1508206988 | B.c.p., Inc. | Home Health | 2200 Main St, Suite 650, Wailuku, HI 96793-1681 | 2013-06-28 |
| 1942569702 | B. C. P., Inc. | Home Health | 2200 Main St, Suite 660, Wailuku, HI 96793-1681 | 2012-05-14 |
| 1356577415 | Thomas Tsung-ping Chen | Psychologist | 2200 Main St, Suite #519, Wailuku, HI 96793-1681 | 2009-06-03 |
| 1316144025 | Carol Geer Freitas | Counselor | 2200 Main St, Suite 518, Wailuku, HI 96793-1654 | 2007-06-27 |
| 1083775431 | Cheri Ann Ewing | Psychologist | 2200 Main St, Ste 524, Wailuku, HI 96793-1624 | 2006-12-12 |
| 1699871392 | Patricia J. Neal | Social Worker | 2200 Main St, #518, Wailuku, HI 96793-1654 | 2006-09-16 |
| 1801821178 | Howard Geoffrey Barbarosh | Internal Medicine | 2200 Main St, Suite 300, Wailuku, HI 96793-1654 | 2006-07-12 |
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|---|---|---|---|---|
| 1699384701 | Laura Covey | Massage Therapist | Wailuku Community Acupuncture, 33 Central Ave, Wailuku, HI 96793 | 2020-07-24 |
| 1750902839 | Massage Therapy and Wellness of Hawai, LLC | Massage Therapist | Massage Therapy and Wellness of Hawaii, 219 Hookahi St Suite 108, Wailuku, HI 96793 | 2020-04-30 |
| 1790329084 | Milba Rojas Melchor | Technician | 932 Wailupe Drive, Wailuku, HI 96793 | 2019-10-30 |
| 1669973863 | Chad Adolpho | Massage Therapist | 95 Mahalani Street, Room 21, Wailuku, HI 96793 | 2018-02-22 |
| 1548785520 | Hookaulike Wellness LLC | Registered Nurse | 720 Kealii Drive, Wailuku, HI 96793 | 2017-08-10 |
| 1932585072 | Back & Body Clinic of Hi, LLC | Massage Therapist | 81 Central Avenue, Wailuku, HI 96793 | 2015-07-30 |
| 1558765719 | Maui Cancer Clinic, Inc. | Clinic/Center | 24 North Church Street Suite 308, Wailuku, HI 96793 | 2014-10-17 |
| 1609275262 | Maui Memorial Medical Center | General Acute Care Hospital | 85 Maui Lani Parkway, Wailuku, HI 96793 | 2014-08-20 |
| 1558780072 | Mental Health Kokua | Community/Behavioral Health | 503 -a Ua Place, Wailuku, HI 96793 | 2014-04-11 |
| 1538584545 | Mental Health Kokua | Assisted Living Facility | 503 Ua Pl, Iao Valley, Wailuku, Maui, HI 96793 | 2014-02-27 |
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| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376599688 | Helenna Nakama | Psychiatry & Neurology | 459 Patterson Rd, Mailcode 00ht, Honolulu, HI 96819-1522 | 2006-05-26 |
| 1013350099 | Gerald J Mckenna M.d. Inc Dba Mckenna Recovery Center | Psychiatry & Neurology | 4374 Kukui Grove St, Ste 104, Lihue, HI 96766-2007 | 2013-04-09 |
| 1922129428 | Julie N Trinh | Psychiatry & Neurology | 45-710 Keaahala Rd, Kaneohe, HI 96744-3528 | 2007-04-02 |
| 1902952385 | Gerald James Mckenna | Psychiatry & Neurology | 4374 Kukui Grove St, Suite 104, Lihue, HI 96766-2007 | 2007-01-26 |
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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.