Blake M Randolph (NPI# 1295382786, PAC ID# 4880926955) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1295382786 |
| PAC ID by PECOS | 4880926955 |
| Professional Enrollment ID | I20191023001966 |
| Full Name | Blake M Randolph |
| Organization Legal Name | ALLEN MEMORIAL HOSPITAL CORPORATION |
| Address |
1825 Logan Ave Waterloo IA 50703-1916 |
| Gender | M |
| Graduation Year | 2019 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4284546045 |
| Number of Group Practice Members | 48 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 160110 | ALLEN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1825 Logan Ave, Waterloo, IA 50703-1916 | ALLEN MEMORIAL HOSPITAL CORPORATION |
| Organization Legal Name | ALLEN MEMORIAL HOSPITAL CORPORATION |
| Physicians | 48 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul Thomas Gellhaus | Urology | Allen Memorial Hospital Corporation | 1717 W Ridgeway Ave, Uph Allen Hospital Center for Urology, Waterloo, IA 50701-4543 |
| Julie M Gleason | Nurse Practitioner | Allen Memorial Hospital Corporation | 3530 W 4th St, Uph Waterloo Community Cancer, Waterloo, IA 50701-4503 |
| Holly L Gaede | Nurse Practitioner | Allen Memorial Hospital Corporation | 233 Vold Dr, Waterloo, IA 50703-1256 |
| Amanda L Vervaecke | Nurse Practitioner | Allen Memorial Hospital Corporation | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Amy M Thurm | Nurse Practitioner | Allen Memorial Hospital Corporation | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Robert Blanken | Physician Assistant | Allen Memorial Hospital Corporation | 146 W Dale St, Waterloo, IA 50703-1901 |
| Charles N Heggen | Diagnostic Radiology | Allen Memorial Hospital Corporation | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Kristen M Grapp | Nurse Practitioner | Allen Memorial Hospital Corporation | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Brandy M Reints | Nurse Practitioner | Allen Memorial Hospital Corporation | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Daniel K Lee | Urology | Allen Memorial Hospital Corporation | 405 E Main St, Uph Marshalltown Urology, Marshalltown, IA 50158-1928 |
| Street Address |
1825 LOGAN AVE |
| City | WATERLOO |
| State | IA |
| Zip | 50703-1916 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kurtis A Lucas | Family Medicine | Iowa Physicians Clinic Medical Foundation | 1825 Logan Ave, Waterloo, IA 50703-1999 |
| Amanda L Vervaecke | Nurse Practitioner | Allen Memorial Hospital Corporation | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Collin J Willhite | Certified Registered Nurse Anesthetist (crna) | Cedar Valley Medical Specialists PC | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Matthew M Willis | Certified Registered Nurse Anesthetist (crna) | Cedar Valley Medical Specialists PC | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Amy M Thurm | Nurse Practitioner | Allen Memorial Hospital Corporation | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Sue A Bruch | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 1825 Logan Ave, Waterloo, IA 50703-1999 |
| Charles N Heggen | Diagnostic Radiology | Allen Memorial Hospital Corporation | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Kristen M Grapp | Nurse Practitioner | Allen Memorial Hospital Corporation | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Cole H Asay | Certified Registered Nurse Anesthetist (crna) | Cedar Valley Medical Specialists PC | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| James C Nesler | Anesthesiology | Cedar Valley Medical Specialists PC | 1825 Logan Ave, Waterloo, IA 50703-1916 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Emily A Grarup | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 2140 Logan Ave, Suite C, Waterloo, IA 50703-1002 |
| Sapna N Patel | Family Medicine | Iowa Physicians Clinic Medical Foundation | 2140 Logan Ave, Suite C, Waterloo, IA 50703-1002 |
| Sherry Khurana | Family Medicine | Iowa Physicians Clinic Medical Foundation | 2160 Logan Ave, Waterloo, IA 50703-1006 |
| Cody Lafler | Occupational Therapy | Iowa Physicians Clinic Medical Foundation | 2160 Logan Ave, Waterloo, IA 50703-1006 |
| Alison J Jayme | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 2134 Logan Ave, Suite A, Waterloo, IA 50703-1022 |
| Katie C Wilcox | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 2134 Logan Ave, Suite A, Waterloo, IA 50703-1022 |
| Maggie M Austin | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 2134 Logan Ave, Suite A, Waterloo, IA 50703-1022 |
| Elizabeth R Batterson | Nurse Practitioner | Cedar Valley Medical Specialists PC | 419 E Donald St, Waterloo, IA 50703-1223 |
| Holly L Gaede | Nurse Practitioner | Allen Memorial Hospital Corporation | 233 Vold Dr, Waterloo, IA 50703-1256 |
| Jean Marie Hoy | Nurse Practitioner | Allen Memorial Hospital Corporation | 233 Vold Dr, Waterloo, IA 50703-1256 |
| Find all physicians in zip 50703 | |||
| City | WATERLOO |
| Zip Code | 50703 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WATERLOO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Blake M Randolph.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.