| Amy Randolph, MED, CCC-SLP | |
|
35 Referendum Dr Ne, Bolivia, NC 28422-7578 | |
| (910) 406-5100 | |
| Not Available |
| Full Name | Amy Randolph |
|---|---|
| Gender | Female |
| Speciality | Qualified Speech Language Pathologist |
| Experience | 28 Years |
| Location | 35 Referendum Dr Ne, Bolivia, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295910057 | NPI | - | NPPES |
| 7411551 | Medicaid | NC | |
| 11945 | Other | NC | BCBS PROVIDER # |
| 5025 | Other | NC | NC LICENSE # |
| 7211429 | Other | NC | MEDICAID GROUP PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 5639 (South Carolina) | Secondary |
| 235Z00000X | Speech-language Pathologist | 5025 (North Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Empowerme Rehabilitation Llc | 2769723162 | 435 |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Randolph, MED, CCC-SLP 4974 Kona Ct Unit 2, Southport, NC 28461-7576 Ph: (910) 599-6994 | Amy Randolph, MED, CCC-SLP 35 Referendum Dr Ne, Bolivia, NC 28422-7578 Ph: (910) 406-5100 |
Journee Rebekah Matthews, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 35 Referendum Dr Ne, Bolivia, NC 28422 Phone: 910-228-4876 | |
Jaclyn J Oehler, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 35 Referendum Dr Ne, Bolivia, NC 28422 Phone: 910-406-5100 | |
Ryleigh Weber, MS Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 35 Referendum Dr Ne, Bolivia, NC 28422 Phone: 910-406-5100 Fax: 866-293-0649 | |
Mrs. Amanda Mizelle, M.S.CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 35 Referendum Dr Ne, Bolivia, NC 28422 Phone: 910-406-5100 Fax: 866-293-0649 | |
Ann M. Koehler, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1070 Old Ocean Highway, Universal Healthcare Brunswick, Bolivia, NC 28422 Phone: 910-755-5955 | |
Anita Bakula, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 35 Referendum Dr Ne, Bolivia, NC 28422 Phone: 910-406-5100 Fax: 866-293-0649 |