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MR. RANDOLPH S HARRISON PA
NPI 1104962620
Physician Assistant in Fort George G Meade, MD

Active since January 30, 2007PECOS Enrolled
2480 LLEWELLYN AVE, FORT GEORGE G MEADE, MD 20755(301) 677-8798 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Randolph S Harrison Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RANDOLPH S HARRISON PA (NPI 1104962620) is an individual physician assistant in Fort George G Meade, Maryland, licensed in Florida (1070437) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in Vienna, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1104962620
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. RANDOLPH S HARRISONCredential: PA
Location Address2480 LLEWELLYN AVEFort George G Meade, MD 20755-7081
Mailing Address2480 Llewellyn AveFort George G Meade, MD 20755-7081
Phone(301) 677-8798
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateJanuary 30, 2007
Last NPPES UpdateApril 17, 2025
NPPES CertifiedApril 17, 2025
✔ NPI 1104962620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in FL · 1070437
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2480 LLEWELLYN AVE, Fort George G Meade, MD 20755
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Secondary Practice Location 1

Location 1305 Maple Ave WVienna, VA 22180-4306 · Phone (703) 992-7779

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Randolph S Harrison Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7113405127
PECOS Enrollment IDI20260131000451
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20755 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.08 typical visit price
range $60.73 – $183.44
Typical copayment $23.52 (range $15.18 – $45.86)
Most-billed visit code 99203
Established Patient
$75.47 typical visit price
range $19.60 – $149.17
Typical copayment $18.86 (range $4.90 – $37.29)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JOANNE HILL RN
Registered Nurse (Ambulatory Care)
2480 LLEWELLYN AVE
FORT GEORGE G MEADE, MD 20755
Anne Arundel County (301) 677-8854
JENNIE LINN WILLIAMS
Social Worker (Clinical)
2480 LLEWELLYN AVE
FORT MEADE, MD 20755
Anne Arundel County (301) 677-8741
GILBERT CARL LONG LVN
Licensed Vocational Nurse
2480 LLEWELLYN AVE
FORT GEORGE G MEADE, MD 20755
Anne Arundel County (301) 677-8270
JANNA LAMBSON O.D.
Optometrist
2480 LLEWELLYN AVE
FORT GEORGE G MEADE, MD 20755
Anne Arundel County (301) 677-8813
PATRICIA GINDLESBERGER
Social Worker (Clinical)
2480 LLEWELLYN AVE
FORT GEORGE G MEADE, MD 20755
Anne Arundel County (301) 677-9530
MS. LAUREN MICHELE ABBOTT PA
Physician Assistant
2480 LLEWELLYN AVE
FORT GEORGE G MEADE, MD 20755
Anne Arundel County (410) 436-3001
MRS. YOLANDA NICOLE NELSON
Nurse's Aide
2480 LLEWELLYN AVE
FORT GEORGE G MEADE, MD 20755
Anne Arundel County (301) 677-8949
SHELIA FAYE RAMSEY-CALDWELL LCSW-C
Social Worker (Clinical)
2480 LLEWELLYN AVE, KIMBROUGH AMBULATORY CARE CENTER
FORT GEORGE G MEADE, MD 20755
Anne Arundel County (301) 677-8461

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randolph Harrison's NPI number?

The NPI number for Randolph Harrison is 1104962620. It was assigned to this individual provider in the NPPES registry on January 30, 2007.

Where is Randolph Harrison located?

Randolph Harrison practices at 2480 Llewellyn Ave, Fort George G Meade, MD 20755. The listed phone number is (301) 677-8798.

What is Randolph Harrison's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Randolph Harrison enrolled in Medicare?

Yes. Randolph Harrison is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Randolph Harrison was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.