RICHARD C RANDOLPH MD PA
NPI 1679672745
Family Medicine in Brandon, MS
About Richard C Randolph Md Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RICHARD C RANDOLPH MD PA (NPI 1679672745) is a healthcare organization registered as a family medicine in Brandon, Mississippi and active in the NPI registry since September 2006. The organization lists Richard C Randolph, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Richard C Randolph Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Richard C Randolph MD PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Richard C Randolph MD PA's NPI number?
The NPI number for Richard C Randolph MD PA is 1679672745. It was assigned to this organization in the NPPES registry on September 22, 2006.
Where is Richard C Randolph MD PA located?
Richard C Randolph MD PA is located at 348 Crossgates Blvd Suite 2200, Brandon, MS 39042. The listed phone number is (601) 825-2466.
What is Richard C Randolph MD PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Richard C Randolph MD PA enrolled in Medicare?
Yes. Richard C Randolph MD PA is registered in the Medicare PECOS enrollment system.
When is Richard C Randolph MD PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Mississippi, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Richard C Randolph MD PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Richard C Randolph MD PA. 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 Richard C Randolph MD PA was last updated on August 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Richard C Randolph Md Pa · NPI 1679672745
Family Medicine organization in Brandon, Mississippi. Organization record, active in the CMS NPPES registry since September 22, 2006.
## Identity
- **NPI:** 1679672745 (Entity type: Organization)
- **Enumerated:** September 22, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Richard Randolph, PRESIDENT
## Practice location
- **Address:** 348 CROSSGATES BLVD, SUITE 2200, Brandon, MS 39042-2616
- **Phone:** (601) 825-2466 · **Fax:** (601) 824-8137
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 15, 2011
- **Other identifiers:** Medicaid 03920519 (MS); Medicare UPIN B66164 (MS); Other DG3008 (MS); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1679672745) · Data from the CMS NPPES public registry.