RANDOLPH J CORDLE MD NPI 1508896903

NPI Information

NPI: 1508896903
Provider Name: RANDOLPH J CORDLE, MD
Classification: Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

Organization: CAROLINA MEDICORP ENTERPRISES, INC.

PECOS Registration: Yes

Address:
1000 BLYTHE BLVD
CHARLOTTE, NC
ZIP 28203
Phone: (704) 355-2171
Get Directions

Randolph J Cordle, MD is a pediatric emergency medicine pediatrics in Charlotte, NC with 32 years of experience. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. Randolph J Cordle, MD NPI is 1508896903. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduation Year:1992

The provider's business location address is:

1000 BLYTHE BLVD
CHARLOTTE, NC
ZIP 28203-812
Phone: (704) 355-2171
Fax: (704) 355-5736

The NPI 1508896903 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/3/2006 and was last updated on 10/26/2020.

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	207P00000X	Emergency Medicine		200501146	NORTH CAROLINA	No
2	207PP0204X	Emergency Medicine	Pediatric Emergency Medicine	2005-01146	NORTH CAROLINA	No
3	2080P0204X	Pediatrics	Pediatric Emergency Medicine	2005-01146	NORTH CAROLINA	Yes
4	2085U0001X	Radiology	Diagnostic Ultrasound	2005-01146	NORTH CAROLINA	No

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	N46005	MEDICAID	SOUTH CAROLINA
2	5900951	MEDICAID	NORTH CAROLINA
3	140JJ	OTHER	NORTH CAROLINA	NCBCBS

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: 11/14/2023

NPI Synchronization or Removal

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