DR. RANDOLPH PHILIP ROUNTREE (NPI# 1891064150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891064150 |
| Entity Type | Individual |
| Full Name | DR. RANDOLPH PHILIP ROUNTREE |
| Other Name | DR. RANDOLPH PHILIP ROUNTREE |
| Credential | M.D., PSY.D. |
| Practice Address |
1505 S Don Roser Dr Ste A Las Cruces NM 88011-4596 |
| Mailing Address |
Po Box 2005 Woodland Park CO 80866-2005 |
| Practice Telephone | 7192389111 |
| Mailing Telephone | 7192389111 |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2019-12-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
3689 | CO | Behavioral Health & Social Service Providers |
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
C0076 | NM | Behavioral Health & Social Service Providers |
| Street Address |
1505 S DON ROSER DR STE A |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88011-4596 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954648 | Asc of The Heart Institute | Internal Medicine | 1250 N Sonoma Ranch Blvd, Las Cruces, NM 88011 | 2020-08-26 |
| 1104449206 | Kruti Gitesh Shah | Student in an Organized Health Care Education/Training Program | Mountain View Regional Medical Cente, Graduate Medical Education, 4351 E Lohman Ave Suite 300, Las Cruces, NM 88011 | 2020-05-22 |
| 1831719368 | Borna Mansouri | Student in an Organized Health Care Education/Training Program | 4351 E. Lahman Ave, Suite 300, Moutnainview Regional Medical Center Graduta, Las Cruces, NM 88011 | 2020-04-24 |
| 1306474408 | Madonna Petula Phillip | Student in an Organized Health Care Education/Training Program | 4351 E Lohmon Avenue Suite 300, Las Cruces, NM 88011 | 2020-04-01 |
| 1285267849 | Back In Action Therapy of Las Cruces | Occupational Therapist | 4440 Sonoma Ranch Blvd, Suite F, Las Cruces, NM 88011 | 2020-02-21 |
| 1649818725 | Kimberly Ann Smetzer | Registered Nurse | 4401 East Lohman, Building 5, Las Cruces, NM 88011 | 2019-12-19 |
| 1548806375 | Melinda Michelle Fowler | Social Worker | 2605 Terrace Drive, Las Cruces, NM 88011 | 2019-11-27 |
| 1871134692 | Rio Grande Hematology and Oncology, LLC | Internal Medicine | 4391 East Lohman Ave., Las Cruces, NM 88011 | 2019-10-02 |
| 1972083640 | Lorianna R. Narvaez | Counselor | 1155 S. Telshor Suite 302-a, Las Cruces, NM 88011 | 2018-08-21 |
| 1215416524 | Aday Orthodontics, PC | Dentist | 2701 Missouri Ave., Suite D, Las Cruces, NM 88011 | 2018-08-08 |
| Find all providers in zip 88011 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730203860 | Pattijo N Velasquez | Psychologist | 1505 S Don Roser Dr, Ste. A, Las Cruces, NM 88011-4596 | 2007-03-16 |
| 1982024105 | Drw Behavioral Health Services, LLC | Psychologist | 1395 Missouri Ave, Las Cruces, NM 88001-5327 | 2014-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417489378 | Primary Wellness Team Corporation | Psychologist | 5805 Mcnutt Rd, Ste D, Santa Teresa, NM 88008-8001 | 2017-03-30 |
| 1154877371 | J. Michael Mash Prescribing Psychologist LLC | Psychologist | 4155 State Road 68, Unit 6, Rancho De Taos, NM 87557 | 2016-08-28 |
| 1003218553 | Integrated Healthcare of New Mexico | Psychologist | 7632 William Moyers Ave Ne, Albuquerque, NM 87122-2765 | 2014-09-16 |
| 1124466446 | Shekinah Foundation | Psychologist | 3001 S Wyoming Ave, Roswell, NM 88203-2326 | 2013-06-08 |
| 1902197098 | S M Cobb | Psychologist | 400 N Pennsylvania Ave Ste 990, Roswell, NM 88201-4754 | 2011-04-25 |
| 1285232397 | Dr Tony J Kreuch LLC | Psychologist | 2204 Brothers Rd Ste B, Santa Fe, NM 87505-6975 | 2020-10-12 |
| 1245856913 | Paul King-miller Psyd Lpcc LLC | Psychologist | 11216 Brentwood Hills Blvd Ne, Albuquerque, NM 87112-3219 | 2020-06-18 |
| 1548677669 | Winds of Change Mental Health Services, LLC | Psychologist | 108 E High St, Grants, NM 87020-2453 | 2014-07-21 |
| 1477585990 | Deborah Leslie Kos | Psychologist | 4810 Hardware Dr Ne, Albuquerque, NM 87109-2013 | 2006-07-07 |
| City | LAS CRUCES |
| Zip Code | 88011 |
Please comment or provide details below to improve the information on DR. RANDOLPH PHILIP ROUNTREE.
| 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.