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MRS. TAHLIA MAE RANDALL PHYSICIAN ASSISTANT
NPI 1790204055
Physician Assistant in Fayetteville, NC

Active since September 18, 2017PECOS Enrolled
217 GLENSFORD DR, FAYETTEVILLE, NC 28314(910) 483-4647 Get Directions Write a Review

NPPES record last updated: November 14, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 14, 2019, Sep 18, 2017 (2 updates tracked since 2017).

About Mrs. Tahlia Mae Randall Physician Assistant NPPES

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

MRS. TAHLIA MAE RANDALL PHYSICIAN ASSISTANT (NPI 1790204055) is an individual physician assistant in Fayetteville, North Carolina, licensed in North Carolina (10-09313) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Fort Lauderdale.

NPPES Registry Identity

NPI1790204055
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. TAHLIA MAE RANDALLCredential: PHYSICIAN ASSISTANT
Location Address217 GLENSFORD DRFayetteville, NC 28314
Mailing Address217 Glensford DrFayetteville, NC 28314-0892
Phone(910) 483-4647
Sole ProprietorNo
Enumeration DateSeptember 18, 2017
Last NPPES UpdateNovember 14, 20192 updates tracked since enumeration
✔ NPI 1790204055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 10-09313
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
217 GLENSFORD DR, Fayetteville, NC 28314
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Secondary Practice Location 1

Location 11995 E Oakland Park Blvd Ste 250Fort Lauderdale, FL 33306-1149 · Phone (954) 791-6146

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Tahlia Mae Randall Physician Assistant 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28314 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

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

PHYTCARE LLC
Physical Medicine & Rehabilitation
217 GLENSFORD DR
FAYETTEVILLE, NC 28314
Cumberland County (800) 849-5609
VERONICA BAAH FNP
Nurse Practitioner (Family)
217 GLENSFORD DR
FAYETTEVILLE, NC 28314
Cumberland County (540) 373-2424
MATRIX OCCUPATIONAL HEALTH P.C.
Clinic/Center (Urgent Care)
217 GLENSFORD DR, SUITE A
FAYETTEVILLE, NC 28314
Cumberland County (910) 483-4647
MRS. JANE LINGAO PUNZALAN NP-C
Nurse Practitioner (Family)
217 GLENSFORD DR
FAYETTEVILLE, NC 28314
Cumberland County (910) 483-4647
TONYA WAE BROWN FNP
Nurse Practitioner (Family)
217 GLENSFORD DR
FAYETTEVILLE, NC 28314
Cumberland County (910) 483-4647
MATRIX OCCUPATIONAL HEALTH, P.C.
Clinic/Center (Urgent Care)
217 GLENSFORD DR
FAYETTEVILLE, NC 28314
Cumberland County (910) 483-4647
LAUREN KENDALL SHARP FNP
Nurse Practitioner (Family)
217 GLENSFORD DR
FAYETTEVILLE, NC 28314
Cumberland County (910) 483-4647
LINDSEY CATHERINE OBERACKER PA-C
Physician Assistant
217 GLENSFORD DR
FAYETTEVILLE, NC 28314
Cumberland County (910) 483-4647

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 Tahlia Randall's NPI number?

The NPI number for Tahlia Randall is 1790204055. It was assigned to this individual provider in the NPPES registry on September 18, 2017.

Where is Tahlia Randall located?

Tahlia Randall practices at 217 Glensford Dr, Fayetteville, NC 28314. The listed phone number is (910) 483-4647.

What is Tahlia Randall's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tahlia Randall enrolled in Medicare?

Yes. Tahlia Randall is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tahlia Randall was last updated on November 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.