RANDOLPH MEDICAL PRACTICES PA
NPI 1144320052
Family Medicine in Lake City, FL

Q: What is Randolph Medical Practices PA's NPI number?

The NPI number for Randolph Medical Practices PA is 1144320052. It was assigned to this organization in the NPPES registry on September 22, 2006.

Q: What is Randolph Medical Practices PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since September 22, 2006CLIA 10D0703998 · Waiver

1847 SW BARNETT WAY, LAKE CITY, FL 32025(386) 755-1440(386) 758-5628 Get Directions Write a Review

NPPES record last updated: October 31, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Randolph Medical Practices Pa NPPES

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

RANDOLPH MEDICAL PRACTICES PA (NPI 1144320052) is a healthcare organization registered as a family medicine in Lake City, Florida and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through February 29, 2028 and lists Tommy Lavaughn Randolph, Md, as its authorized official.

NPPES Registry Identity

NPI1144320052

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameRANDOLPH MEDICAL PRACTICES PA

Location Address1847 SW BARNETT WAYLake City, FL 32025-6957

Mailing Address1847 Sw Barnett WayLake City, FL 32025-6957 · (386) 755-1440 · Fax (386) 758-5628

Phone(386) 755-1440

Fax(386) 758-5628

Organization SubpartNo

Authorized OfficialTommy Lavaughn RandolphMd · (386) 755-1440

Enumeration DateSeptember 22, 2006

Last NPPES UpdateOctober 31, 2018

✔ NPI 1144320052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · ME46235

Definition

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.

Also ListedPediatricsTaxonomy 208000000X · License ME51982 (FL)

1847 SW BARNETT WAY, Lake City, FL 32025

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Other Identifiers 2

Other38690FL · Bcbs Group Number

Medicaid256113100FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0703998

Randolph Medical Practices PA · Lake City, FL

Active · expires Feb 29, 2028

CLIA Number10D0703998

Laboratory TypePhysician Office

Certificate Effective DateMarch 1, 2026

Certificate Expiration DateFebruary 29, 2028

Laboratory DirectorTommy Randolph

Laboratory Phone(386) 755-1440

Laboratory LocationRandolph Medical Practices PA1847 SW Barnett Way, Lake City, FL 32025

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

MR. MATTHEW NEIL MELVIN ARNP

Nurse Practitioner