MAXWELL BALLARD RANDALL M.D.
NPI 1164955548
Student in an Organized Health Care Education/Training Program in Morgantown, WV

Q: What is Maxwell Randall's NPI number?

The NPI number for Maxwell Randall is 1164955548. It was assigned to this individual provider in the NPPES registry on April 4, 2017.

Q: What is Maxwell Randall's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Maxwell Randall was last updated on April 4, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 04, 2017PECOS Enrolled

1 MEDICAL CENTER DR, MORGANTOWN, WV 26506(304) 293-5323(304) 293-8724 Get Directions Write a Review

NPPES record last updated: April 4, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Maxwell Ballard Randall M.d. NPPES

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

MAXWELL BALLARD RANDALL M.D. (NPI 1164955548) is an individual student in an organized health care education/training program in Morgantown, West Virginia and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164955548

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMAXWELL BALLARD RANDALLCredential: M.D.

Location Address1 MEDICAL CENTER DRMorgantown, WV 26506-1200

Mailing Address1 Medical Center Dr, P.o. Box 9137Morgantown, WV 26506-1200 · (304) 293-5323 · Fax (304) 293-8724

Phone(304) 293-5323

Fax(304) 293-8724

Sole ProprietorNo

Enumeration DateApril 4, 2017

✔ NPI 1164955548 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1 MEDICAL CENTER DR, Morgantown, WV 26506

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maxwell Ballard Randall M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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