MARK PATRICK RANDOLPH (NPI# 1952394629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952394629 |
| Entity Type | Individual |
| Full Name | MARK PATRICK RANDOLPH |
| Credential | PA-C |
| Practice Address |
2503 Wooten Blvd Sw Wilson NC 27893-4426 |
| Mailing Address |
Po Box 3127 Wilson NC 27895-3127 |
| Practice Telephone | 2522432268 |
| Practice Fax Number | 2522432917 |
| Mailing Telephone | 2522432268 |
| Mailing Fax Number | 2522432917 |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2011-01-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
103783 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982677209 | Mark B Randolph | Family Medicine | 1920 Corporate Dr, Suite 208, San Marcos, TX 78666-6077 | 2006-02-08 |
| Street Address |
2503 WOOTEN BLVD SW |
| City | WILSON |
| State | NC |
| Zip Code | 27893-4426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205829066 | Anwar Darwish Al-haidary | Internal Medicine | 2503 Wooten Blvd Sw, Wilson, NC 27893-4426 | 2005-08-26 |
| 1578803219 | Lorie Tyson Collier | Nurse Practitioner | 2503 Wooten Blvd Sw, Wilson, NC 27893-4426 | 2013-02-17 |
| 1013959527 | Roger Weed Lamanna | Internal Medicine | 2503 Wooten Blvd Sw, Wilson, NC 27893-4426 | 2006-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847524 | Graceland Student Services LLC | Early Intervention Provider Agency | 610 Fairview Ave., Wilson, NC 27893 | 2020-09-30 |
| 1508477894 | Evan Michael Abatiell | Specialist/Technologist | 400 Atlantic Christian E West Ne, Wilson, NC 27893 | 2020-08-11 |
| 1679100606 | Newgreen Inhomecare Group Inc | Registered Nurse | 121 Nast Street N, Wilson, NC 27893 | 2020-03-27 |
| 1942772983 | Open Water Medical, Pa | Clinic/Center | 4008 Nc-42, Wilson, NC 27893 | 2018-12-31 |
| 1679043244 | Madison Rose Propst | Social Worker | 2416 Bedgood, Wilson, NC 27893 | 2018-11-27 |
| 1104396753 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 2500 Horton Blvd, Wilson, NC 27893 | 2018-11-27 |
| 1528545498 | North Carolina In-home Partner-viii, LLC | Home Health | 1901 Tarboro St Sw Ste 304, Wilson, NC 27893 | 2018-07-24 |
| 1518478957 | Home Away From Home, Inc. | In Home Supportive Care | 1723 Meadowbrook Lane W., Wilson, NC 27893 | 2017-10-12 |
| 1942721295 | Sandra Susan Blazek | Social Worker | 608 Nash Street Nw, Wilson, NC 27893 | 2017-06-27 |
| 1700306297 | Kimberly Denton Almkuist | Nurse Practitioner | Wilson County Health Department, 1801 Glendale Dr. Sw, Wilson, NC 27893 | 2017-06-26 |
| Find all providers in zip 27893 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003380098 | Emily Lauren Voynovich Nordstrom | Physician Assistant | 3302 Nash St N, Wilson, NC 27896-1232 | 2019-01-14 |
| 1508276544 | Courtney Kopas | Physician Assistant | 2503 Forest Hills Rd W, Wilson, NC 27893-3300 | 2014-04-29 |
| 1790923308 | David C Propst | Physician Assistant | 3302 Nash St N, Wilson, NC 27896-1232 | 2009-02-04 |
| 1750539318 | Andrea Hubbard Barfield | Physician Assistant | 1812 Glendale Dr Sw, Suite B, Wilson, NC 27893-4676 | 2008-09-08 |
| 1578686804 | Mark Eldridge | Physician Assistant | 1725 Tarboro St Sw, Wilson, NC 27893-3428 | 2007-04-10 |
| 1487700449 | Tasha Jean Harris | Physician Assistant | 2546 Ward Blvd, Wilson, NC 27893-1600 | 2007-01-25 |
| 1285705152 | Clifton Williams | Physician Assistant | 303 Green St E, Wilson, NC 27893-4105 | 2006-11-13 |
| 1043228729 | Tracy Bowman | Physician Assistant | 1705 Tarboro St Sw, Wilson, NC 27893-3428 | 2006-08-04 |
| 1669433371 | Catherine S Warren | Physician Assistant | 2130 Forest Hills Rd W, Ste B, Wilson, NC 27893-3681 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403884 | Billy Scott II | Physician Assistant | 3000 Rogers Rd Ste 100, Wake Forest, NC 27587-5745 | 2020-10-05 |
| 1982213765 | Michaela Lynne Mcbride | Physician Assistant | 9541 Kings Parade Blvd Unit 107, Charlotte, NC 28273-5819 | 2020-07-28 |
| 1386260347 | Elizabeth Warrington Maiche | Physician Assistant | 113 Montgomery Dr, Saluda, NC 28773-7787 | 2020-06-24 |
| 1831715663 | John Wheary | Physician Assistant | 3233 Austin Ave, New Bern, NC 28562-7084 | 2020-06-17 |
| 1629692439 | Julie Anne Augustine | Physician Assistant | 718 S Green St, Winston Salem, NC 27101-5112 | 2020-06-08 |
| 1659995710 | Kristopher Neal Priddy | Physician Assistant | 405 Forest Hill Dr, Shelby, NC 28150-5520 | 2020-06-04 |
| 1710500558 | Christian Wright Fulenwider | Physician Assistant | 104 Linden St, Morganton, NC 28655-3788 | 2020-05-27 |
| 1366065500 | Lisa Lynn Carder | Physician Assistant | 904 Foxcroft Cir Apt D, Shelby, NC 28152-6868 | 2020-05-22 |
| 1982234282 | Brandon Sorkin | Physician Assistant | 280 Executive Park Drive, Suite 100, Concord, NC 28025-2802 | 2020-01-25 |
| 1245860618 | Robert Maughan | Physician Assistant | 129 Bryce Creek Ln, Fayetteville, NC 28303-4981 | 2020-01-24 |
| Find all providers with the same taxonomy | ||||
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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.