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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. GREGORY W RANDOLPH MD
NPI 1699760652
General Practice in Pass Christian, MS

Active since September 15, 2005PECOS Enrolled
130 FLEITAS AVE, PASS CHRISTIAN, MS 39571(228) 452-4888(228) 452-5006 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Gregory W Randolph Md NPPES

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

MR. GREGORY W RANDOLPH MD (NPI 1699760652) is an individual general practice provider in Pass Christian, Mississippi, licensed in Mississippi (13081) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699760652
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameMR. GREGORY W RANDOLPHCredential: MD
Location Address130 FLEITAS AVEPass Christian, MS 39571-4507
Mailing Address130 Fleitas AvePass Christian, MS 39571-4507 · (228) 452-4888 · Fax (228) 452-5006
Phone(228) 452-4888
Fax(228) 452-5006
Sole ProprietorNo
Enumeration DateSeptember 15, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1699760652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MS · 13081
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
130 FLEITAS AVE, Pass Christian, MS 39571
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Other Identifiers 1

Medicaid00117253MS

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Gregory W Randolph Md 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.

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 Gregory Randolph's NPI number?

The NPI number for Gregory Randolph is 1699760652. It was assigned to this individual provider in the NPPES registry on September 15, 2005.

Where is Gregory Randolph located?

Gregory Randolph practices at 130 Fleitas Ave, Pass Christian, MS 39571. The listed phone number is (228) 452-4888.

What is Gregory Randolph's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Gregory Randolph enrolled in Medicare?

Yes. Gregory Randolph is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gregory Randolph was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 30 days 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.