Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicholas Shane Randolph, PTA

Individual provider Physical Therapy Assistant · NPI 1528765179

Nicholas Shane Randolph, PTA is a Physical Therapy Assistant in Miami, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2023
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

2225 N Main St
Miami, OK 74354-1620
Phone: (918) 542-4101
Fax: (918) 542-4410
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2852 (OK)

Record details

NPI number1528765179
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorYes
NPI enumeratedFebruary 14, 2023
Last updated in NPPESFebruary 14, 2023
Certification dateFebruary 14, 2023

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