Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1760119622 Individual Practitioner Female Practitioner

Tara Randolph , PNP

Nurse Practitioner - Pediatrics • Minnetonka, MN

Professional Overview & Biography Verified Profile Summary

Tara Randolph, PNP is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Minnetonka, MN. Practice services are available at 17705 HUTCHINS DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

17705 Hutchins Dr

Minnetonka, MN 553454145

Telephone 9524018252
Fax 9524018286
Associated Practice Facility / Clinic
🏢 South Lake Clinic, P.a. Facility NPI 1427027184

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Minnetonka, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 5.0 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
20 Specialists

Practicing in Minnetonka, MN (480 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

CMS Verified: 2022-07-28
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License MN 9228

Definition to come...

Practice Associates & Co-Workers

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

1 Associated Practitioners
NPI 1235439548

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active August 02, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location August 02, 2022

Registered at 17705 HUTCHINS DR, MINNETONKA, MN 553454145 (Tel: 9524018252)

📍
Updated Business Mailing Address August 02, 2022

Registered at 6100 W 101ST ST, BLOOMINGTON, MN 554381816 (Tel: 6127901297)

👤
Provider Name / Credentials Updated August 02, 2022

Recorded as TARA RANDOLPH, PNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 02, 2022

Nurse Practitioner (License #9228 in MN)

🟢
Initial NPI Registration & Enumeration August 02, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1760119622
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 02, 2022
Last Update: August 02, 2022
Sole Proprietor: No

Mailing Address

6100 W 101st St

Bloomington, MN 554381816

Phone: 6127901297

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.