RANDOLPH MEDICAL PRACTICES PA NPI 1144320052

NPI Information

  • NPI: 1144320052
  • Provider Name: RANDOLPH MEDICAL PRACTICES PA
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 10D0703998
  • Address: 1847 SW BARNETT WAY
    LAKE CITY, FL
    ZIP 32025
  • Phone: (386) 755-1440

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NPI Details

RANDOLPH MEDICAL PRACTICES PA is a family medicine in Lake City, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. RANDOLPH MEDICAL PRACTICES PA NPI is 1144320052. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1847 SW BARNETT WAY
LAKE CITY, FL
ZIP 32025-957
Phone: (386) 755-1440
Fax: (386) 758-5628

The provider's authorized official is Tommy Lavaughn Randolph .
The authorized official title is Md and has the following contact phone number (386) 755-1440.

The CLIA number assigned to this NPI record is 10D0703998 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 10/31/2018.

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
1208000000XPediatricsME51982FLORIDANo
2207Q00000XFamily MedicineME46235FLORIDAYes

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
138690OTHERFLORIDABCBS GROUP NUMBER
2256113100MEDICAIDFLORIDA

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: 11/21/2025

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