TAKIRA RANDOLPH (APRN) – Family Nurse Practitioner, NPI 1316419369

TAKIRA RANDOLPH (APRN) is a healthcare provider. based in Tallahassee, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. APRN11000261 (FL). The NPI Number for TAKIRA RANDOLPH (APRN) is 1316419369

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
TAKIRA RANDOLPH (APRN)
NPI
1316419369
Phone
(850) 284-0317
Address
4064 BUSTER RD
Enumeration Date
31 December 2018
Last Update Date
29 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8509844735
Graduation Year
2018 (8 years ago)
PAC ID
8628594611
Group Practice PAC ID
6103737697
Professional Enrollment ID
I20250502001584
Address ID
FL323462151PA1328XHWYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

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Provider Addresses for TAKIRA RANDOLPH (APRN)

  • 4064 BUSTER RD

    TALLAHASSEE, FL 323058338

    Phone: (850) 284-0317

    Type: Mailing

  • Patients First, 1690, North Monroe Street, Tallahassee, Leon County, Florida, 32303, United States

    TALLAHASSEE, FL 323035533

    Phone: (850) 284-0317

    Type: Location

  • 2804 REMINGTON GREEN CIR STE 2

    TALLAHASSEE, FL 323081550

    Phone: (850) 385-4494

    Type: Mailing

  • 1328 COASTAL HWY

    PANACEA, FL 323462151

    Phone: (850) 984-4735

    Fax: (850) 984-4742

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-05-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250502001584INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32305)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103737697View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm TAKIRA RANDOLPH (APRN)'s NPI?
Yes. TAKIRA RANDOLPH (APRN) is listed with NPI 1316419369 in the public NPI dataset.
Can I rely on TAKIRA RANDOLPH (APRN) being an active provider?
As of the registry snapshot, TAKIRA RANDOLPH (APRN) is marked active.
What is TAKIRA RANDOLPH (APRN)'s specialty?
The listing groups TAKIRA RANDOLPH (APRN) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does TAKIRA RANDOLPH (APRN) list a practice location?
Patients near Tallahassee, Florida may find TAKIRA RANDOLPH (APRN) in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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