Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mark Patrick Randolph, PA-C

Individual provider Medical Physician Assistant · NPI 1952394629

Mark Patrick Randolph, PA-C is a Physician Assistant in Wilson, North Carolina. Qualified in 2003, 23 years ago. Practices with Vidant Medical Group LLC, a 974-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
23
Licensed in
NC
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2503 Wooten Blvd SW
Wilson, NC 27893-4426
Phone: (252) 243-2268
Fax: (252) 243-2917
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 103783 (NC)

Record details

NPI number1952394629
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 26, 2005
Last updated in NPPESDecember 8, 2020
Certification dateDecember 8, 2020
Mailing addressPo Box 3127, Wilson, NC 27895-3127

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Vidant Medical Group Llc — 974 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Wilson