MR. VAN MCKINLEY RANDOLPH NPI 1306324306

NPI Information

NPI: 1306324306
Provider Name: MR. VAN MCKINLEY RANDOLPH
Classification: Home Health Aide - 374U00000X
Entity Type: Individual
Address:
1501 FORT DAVIS ST SE
WASHINGTON, DC
ZIP 20020
Phone: (202) 808-9369
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MR. Van Mckinley Randolph is a home health aide in Washington, DC. The provider is a person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. MR. Van Mckinley Randolph NPI is 1306324306. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1501 FORT DAVIS ST SE
WASHINGTON, DC
ZIP 20020-025
Phone: (202) 808-9369

The enumeration date for this NPI number is 8/1/2018 and was last updated on 8/1/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	374U00000X	Home Health Aide				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00531676	MEDICAID	DISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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