Jessica Randolph, LPC, PA is a medicare enrolled "Physician Assistant - Medical" provider in Tahlequah, Oklahoma. She graduated from healthcare school in 2020 and has 5 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Cherokee Nation and her current practice location is
100 S Bliss Ave, Tahlequah, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 458-3100.
Jessica Randolph is licensed to practice in Oklahoma (license number 3205) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1174842215.
Healthcare Provider's Profile
| Full Name | Jessica Randolph |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 5 Years |
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| Location | 100 S Bliss Ave, Tahlequah, Oklahoma |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jessica Randolph graduated from medical school in 2020
NPI Data:
- NPI Number: 1174842215
- Provider Enumeration Date: 05/28/2010
- Last Update Date: 09/20/2024
Medicare PECOS Information:
- PECOS PAC ID: 8224459714
- Enrollment ID: I20200609003134
Medical Identifiers
Medical identifiers for Jessica Randolph such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1174842215 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 5388 (Oklahoma) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 3205 (Oklahoma) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Cherokee Nation | 5799698742 | 361 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Randolph is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jessica Randolph, LPC, PA
100 S Bliss Ave,
Tahlequah, OK 74464-2512
Ph: (918) 458-3100 | Jessica Randolph, LPC, PA
100 S Bliss Ave,
Tahlequah, OK 74464-2512
Ph: (918) 458-3100 |
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