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Active NPI 1295910057 Individual Practitioner Female Practitioner

Amy Randolph , MED, CCC-SLP

Speech-Language Pathologist • Bolivia, NC

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Amy Randolph, MED, CCC-SLP is a certified Speech-Language Pathologist practicing in Bolivia, NC. With approximately 28 years of clinical experience since completing medical education in 1998, Amy Randolph delivers high-quality medical care to the local community at 35 REFERENDUM DR NE.

Amy Randolph is affiliated with Empowerme Rehabilitation Llc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

35 Referendum Dr Ne

Bolivia, NC 284227578

Telephone 9104065100
Associated Practice Facility / Clinic
🏢 Brunswick County Schools Facility NPI 1225158793

Medicare Profile & Education

Medical School

Other

Graduation Year

1998

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Bolivia, NC

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
28 Yrs Matches City Avg
City Avg: 28.0 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
22 Specialists

Practicing in Bolivia, NC (7242 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

Clinical Seniority & Experience Comparison

Dr. Randolph (28 Years) 28 Yrs
Bolivia Specialty Average (28.0 Years) 28.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-03-31
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License NC 5025

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

State License SC 5639

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
7411551 (NC)
Commercial Insurance / Payer ID Bcbs Provider #
11945 (NC)
Commercial Insurance / Payer ID Nc License #
5025 (NC)
Commercial Insurance / Payer ID Medicaid Group Provider #
7211429 (NC)

Hospital & Practice Group Affiliations

Empowerme Rehabilitation Llc

2771 Compass Pointe S Wynd Ne, Leland, NC 284516491

Phone: 9107015177

Empowerme Rehabilitation Llc

3600 Park Rd, Charlotte, NC 282094102

Phone: 9802033585

Practice Associates & Co-Workers

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

23 Associated Practitioners
Jaclyn Oehler , MS, CCC-SLP

Speech-Language Pathologist

NPI 1114369683

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Ryleigh Weber , MS

Speech-Language Pathologist

NPI 1114805132

Master of Science

Amanda Mizelle , MSCCC-SLP

Speech-Language Pathologist

NPI 1124156435

MSCCCSLP

Alison Slomba , OTR, L

Occupational Therapist

NPI 1134856610

Occupational Therapist Registered, L

Anita Bakula , SLP

Speech-Language Pathologist

NPI 1184719866

Speech-Language Pathologist

Selena Ehlert , OTR, L

Occupational Therapist

NPI 1194665919

Occupational Therapist Registered, L

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location March 31, 2026

Registered at 35 REFERENDUM DR NE, BOLIVIA, NC 284227578 (Tel: 9104065100)

📍
Updated Business Mailing Address March 31, 2026

Registered at 4974 KONA CT UNIT 2, SOUTHPORT, NC 284617576 (Tel: 9105996994)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 23, 2025

Speech-Language Pathologist (License #5639 in SC)

NPI Profile Active June 01, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location June 01, 2011

Registered at 8810 LAUREL RUN DR, CHARLOTTE, NC 282696162 (Tel: 9105996994)

📍
Updated Business Mailing Address June 01, 2011

Registered at 8810 LAUREL RUN DR, CHARLOTTE, NC 282696162 (Tel: 9105996994)

👤
Provider Name / Credentials Updated June 01, 2011

Recorded as AMY RANDOLPH, M.ED., CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 01, 2011

Speech-Language Pathologist (License #5025 in NC)

🟢
Initial NPI Registration & Enumeration December 29, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1295910057
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 29, 2007
Last Update: March 31, 2026
Sole Proprietor: Yes

Mailing Address

4974 Kona Ct Unit 2

Southport, NC 284617576

Phone: 9105996994

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.