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NPI · 1104205343 · NPPES-sourced

Derrick Randdolf MD

ActiveFamily Medicine
NPI Number
1104205343
Type 1 · Individual
Taxonomy Code
207Q00000X
Contact
(432) 703-5375
License TX · R4622
Last Updated
Enumerated
Primary practice addressTX · 79763-4206
701 W 5th StOdessa, TX 79763-4206
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About this NPIWhat this record shows.

NPI 1104205343 is registered to Derrick Randdolf MD, a Family Medicine practising at 701 W 5th St in Odessa, Texas. Family Medicine physicians provide comprehensive primary care for patients of all ages, including preventive care, chronic disease management, and acute illness treatment. Derrick Randdolf MD has been enumerated in the National Provider Identifier (NPI) registry since 2015.

Provider type
Individual (Type 1)
Status
Active
Enumerated
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Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Practitioner

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Derrick Randdolf MD accepts. To confirm in-network status with your specific health plan, contact Derrick Randdolf MD directly at (432) 703-5375.

Frequently asked

Yes. NPI 1104205343 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Family Medicine physicians provide comprehensive primary care for patients of all ages, including preventive care, chronic disease management, and acute illness treatment.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (432) 703-5375.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Derrick Randdolf MD is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy207Q00000X
Last updated
Enumerated
StatusActive
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6 records · same addressOther providers at this location.

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Same specialtyOther Family Medicine providers in Texas.

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Adjacent in the NPPES enumeration sequenceNPIs enumerated around this one.

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