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RANDALL DERMATOLOGY, PC
NPI 1245340488
Dermatology in West Lafayette Bra, IN

Active since August 30, 2006CLIA Certified · 5 labs
124 SAGAMORE PKWY W, WEST LAFAYETTE BRA, IN 47906(765) 463-6722(765) 463-0905 Get Directions Write a Review

NPPES record last updated: December 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 19, 2024, Aug 22, 2020 (2 updates tracked since 2020).

About Randall Dermatology, Pc NPPES

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

RANDALL DERMATOLOGY, PC (NPI 1245340488) is a healthcare organization registered as a dermatology in West Lafayette Bra, Indiana and active in the NPI registry since August 2006. The organization holds 5 active CLIA laboratory certificates and lists John K Randall, President/owner, as its authorized official.

NPPES Registry Identity

NPI1245340488
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameRANDALL DERMATOLOGY, PC
Location Address124 SAGAMORE PKWY WWest Lafayette Bra, IN 47906-1569
Mailing Address124 Sagamore Pkwy WWest Lafayette Bra, IN 47906-1569 · (765) 463-6722 · Fax (765) 463-0905
Phone(765) 463-6722
Fax(765) 463-0905
Organization SubpartNo
Authorized OfficialJohn K RandallPresident/owner · (765) 463-6722
Enumeration DateAugust 30, 2006
Last NPPES UpdateDecember 19, 20242 updates tracked since enumeration
NPPES CertifiedDecember 19, 2024
✔ NPI 1245340488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in IN · 01042716
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X · License 01042716 (IN)
Also ListedPhysician AssistantTaxonomy 363A00000X · License 10000699A (IN)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 710013695B (IN), 71001017A (IN)
124 SAGAMORE PKWY W, West Lafayette Bra, IN 47906
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Other Identifiers 1

Medicaid200207110AIN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 5

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 15D2143506

Randall Dermatology, PC · Rensselaer, IN
Active · expires Jan 30, 2028
CLIA Number15D2143506
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2026
Certificate Expiration DateJanuary 30, 2028
Laboratory DirectorJohn K. Randall
Laboratory Phone(765) 463-6722
Laboratory LocationRandall Dermatology, PC1201 N Mckinley Ave, Rensselaer, IN 47978
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D2143507

Randall Dermatology, PC · Westfield, IN
Active · expires Jan 30, 2028
CLIA Number15D2143507
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2026
Certificate Expiration DateJanuary 30, 2028
Laboratory DirectorJohn K. Randall
Laboratory Phone(765) 463-6722
Laboratory LocationRandall Dermatology, PC201 N Union St, Westfield, IN 46074
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D2143508

Randall Dermatology, PC · Terre Haute, IN
Active · expires Jan 30, 2028
CLIA Number15D2143508
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2026
Certificate Expiration DateJanuary 30, 2028
Laboratory DirectorJohn K. Randall
Laboratory Phone(765) 463-6722
Laboratory LocationRandall Dermatology, PC4949 E Poplar Dr, Terre Haute, IN 47803
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 15D1037471

Randall Dermatology PC · Kokomo, IN
Active · expires Jun 5, 2027
CLIA Number15D1037471
Laboratory TypePhysician Office
Certificate Effective DateJune 6, 2025
Certificate Expiration DateJune 5, 2027
Laboratory DirectorJohn K. Randall
Laboratory Phone(765) 463-6722
Laboratory LocationRandall Dermatology PC620 S Berkley Rd, Kokomo, IN 46901
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 15D0910366

Randall Dermatology PC · West Lafayette, IN
Active · expires Jan 29, 2027
CLIA Number15D0910366
Laboratory TypePhysician Office
Certificate Effective DateJanuary 30, 2025
Certificate Expiration DateJanuary 29, 2027
Laboratory DirectorJohn K. Randall
Laboratory Phone(765) 463-6722
Laboratory LocationRandall Dermatology PC124 Sagamore Pkwy W, West Lafayette, IN 47906
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 6

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

LAURA L WAVRA NP
Nurse Practitioner (Family)
124 SAGAMORE PKWY W
WEST LAFAYETTE, IN 47906
Tippecanoe County (765) 463-6722
KATRINA N MASTERSON NP
Nurse Practitioner
124 SAGAMORE PKWY W
WEST LAFAYETTE, IN 47906
Tippecanoe County (765) 463-6722
NICOLE M SHERER ARNP
Nurse Practitioner
124 SAGAMORE PKWY W
WEST LAFAYETTE, IN 47906
Tippecanoe County (765) 463-6722
KATHY J ARNOLD NP
Nurse Practitioner
124 SAGAMORE PKWY W
WEST LAFAYETTE BRA, IN 47906
Tippecanoe County (765) 463-6722
DR. JOHN K RANDALL RPH, MD
Dermatology (MOHS-Micrographic Surgery)
124 SAGAMORE PKWY W
WEST LAFAYETTE, IN 47906
Tippecanoe County (765) 463-6722
THERESA E COYNER NP
Nurse Practitioner
124 SAGAMORE PKWY W
WEST LAFAYETTE, IN 47906
Tippecanoe County (765) 463-6722

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 Randall Dermatology, PC's NPI number?

The NPI number for Randall Dermatology, PC is 1245340488. It was assigned to this organization in the NPPES registry on August 30, 2006.

Where is Randall Dermatology, PC located?

Randall Dermatology, PC is located at 124 Sagamore Pkwy W, West Lafayette Bra, IN 47906. The listed phone number is (765) 463-6722.

What is Randall Dermatology, PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Randall Dermatology, PC hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Randall Dermatology, PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Randall Dermatology, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Randall Dermatology, PC was last updated on December 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.