HEATHER W. RANDOLPH (PSY.D.) – Clinical Psychologist, NPI 1861659302

HEATHER W. RANDOLPH (PSY.D.) is a healthcare provider. based in Louisville, Kentucky. specializing in Clinical Psychologist. They hold the professional credentials PSY.D.. They hold a License No. 1491 (KY). The NPI Number for HEATHER W. RANDOLPH (PSY.D.) is 1861659302

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
HEATHER W. RANDOLPH (PSY.D.)
NPI
1861659302
Phone
(502) 423-1151
Address
7511 NEW LAGRANGE RD
Enumeration Date
21 May 2008
Last Update Date
15 April 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5024231151
Graduation Year
2005 (21 years ago)
PAC ID
0345300554
Group Practice PAC ID
9133019466
Professional Enrollment ID
I20081118000553
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

Provider Addresses for HEATHER W. RANDOLPH (PSY.D.)

  • 7511 NEW LAGRANGE RD

    LOUISVILLE, KY 402224859

    Phone: (502) 423-1151

    Fax: (502) 423-1748

    Mailing address matches the actual address.

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: 2008-11-18

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
I20081118000553IClinical PsychologistKYTBD

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 40222)

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Provider's Procedures

HEATHER W. RANDOLPH (PSY.D.) performs procedures in Clinical Psychologist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHOLOGIST, CLINICALKY96118Neuropsychological testing, interpretation, and report by psychologist or physician per hour10912

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: 9133019466View full group profile

Reviews

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Frequently asked questions

What federal number belongs to HEATHER W. RANDOLPH (PSY.D.)?
The federal identifier for HEATHER W. RANDOLPH (PSY.D.) is NPI 1861659302.
Does this profile mean HEATHER W. RANDOLPH (PSY.D.) is currently active?
Yes — HEATHER W. RANDOLPH (PSY.D.) appears active in the national provider directory.
What kind of provider is HEATHER W. RANDOLPH (PSY.D.)?
The page reflects Clinical Psychologist for HEATHER W. RANDOLPH (PSY.D.). Clinical services aligned with this taxonomy classification.
Where is HEATHER W. RANDOLPH (PSY.D.)'s primary listing?
We display Louisville, Kentucky because that is what the record indicates for HEATHER W. RANDOLPH (PSY.D.).
How can I contact HEATHER W. RANDOLPH (PSY.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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