Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1972603876 Deactivated / Inactive NPI Female Practitioner

Dr. Athena R Randolph , MD

Pediatrics • Lake City, FL

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Athena Randolph has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 22, 2006
NPI Deactivation Date March 12, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Athena Randolph, MD was a registered Pediatrics practicing in Lake City, FL. Throughout an active medical career spanning 15 years, Dr. Randolph provided care at the practice location at 1847 SW BARNETT WAY until profile deactivation on 2021-03-12.

Practice Location & Contact Primary Location

Practice Address

1847 Sw Barnett Way

Lake City, FL 320256957

Telephone 3867551440
Fax 3867585628
Associated Practice Facility / Clinic
🏢 Randolph Medical Practices Pa Facility NPI 1144320052

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Lake City, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
8 Specialists

Practicing in Lake City, FL (4160 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License FL ME51982

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1992805881

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated March 12, 2021

Record deactivated on March 12, 2021

NPI Profile Active January 03, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location January 03, 2014

Registered at 1847 SW BARNETT WAY, LAKE CITY, FL 320256957 (Tel: 3867551440)

📍
Updated Business Mailing Address January 03, 2014

Registered at 1847 SW BARNETT WAY, LAKE CITY, FL 320256957 (Tel: 3867551440)

👤
Provider Name / Credentials Updated January 03, 2014

Recorded as ATHENA RANDOLPH, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 03, 2014

Pediatrics (License #ME51982 in FL)

🟢
Initial NPI Registration & Enumeration September 22, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Athena Randolph. Be the first to share your experience!

Sign in to leave a review for Dr. Athena Randolph

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1972603876
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 22, 2006
Last Update: January 03, 2014
Deactivation Date: March 12, 2021

Mailing Address

1847 Sw Barnett Way

Lake City, FL 320256957

Phone: 3867551440

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.