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LAURA C. RANDOLPH MD SC
NPI 1255527727
Clinic/Center - Medical Specialty in Bloomington, IL

Active since September 19, 2007
2502 E EMPIRE ST, SUITE C, BLOOMINGTON, IL 61704(309) 664-6222(309) 664-5006 Get Directions Write a Review

NPPES record last updated: September 19, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Laura C. Randolph Md Sc NPPES

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

LAURA C. RANDOLPH MD SC (NPI 1255527727) is a healthcare organization registered as a medical specialty in Bloomington, Illinois and active in the NPI registry since September 2007. The organization lists Rita Dempsey, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1255527727
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameLAURA C. RANDOLPH MD SC
Location Address2502 E EMPIRE ST, SUITE CBloomington, IL 61704-3738
Mailing Address2502 E Empire St, Suite CBloomington, IL 61704-3738 · (309) 664-6222 · Fax (309) 664-5006
Phone(309) 664-6222
Fax(309) 664-5006
Organization SubpartNo
Authorized OfficialRita DempseyOffice Manager · (309) 664-6222
Enumeration DateSeptember 19, 2007
✔ NPI 1255527727 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in IL · 36100030
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
2502 E EMPIRE ST, Bloomington, IL 61704
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Other Identifiers 5

OtherP00193845IL · Railroad Medicare
Other5732066IL · Blue Cross Blue Shield
Other097565IL · Health Alliance
Medicare PIN209832IL
Other686867IL · Health Link

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Laura C. Randolph Md Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Laura C. Randolph MD Sc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Laura Randolph, M.D.
Plastic and Reconstructive Surgery
NPI 1710906557
2502 E EMPIRE ST SUITE C
Bloomington, IL 61704
(309) 664-6222
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Laura C. Randolph MD Sc's NPI number?

The NPI number for Laura C. Randolph MD Sc is 1255527727. It was assigned to this organization in the NPPES registry on September 19, 2007.

Where is Laura C. Randolph MD Sc located?

Laura C. Randolph MD Sc is located at 2502 E Empire St Suite C, Bloomington, IL 61704. The listed phone number is (309) 664-6222.

What is Laura C. Randolph MD Sc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is Laura C. Randolph MD Sc enrolled in Medicare?

Yes. Laura C. Randolph MD Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Laura C. Randolph MD Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Laura C. Randolph MD Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Laura C. Randolph MD Sc was last updated on September 19, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.