Randall Grove, PA
NPI 1619969250 · Physician Assistant · Myrtle Beach, SC
Enrolled with Medicare as Order and Referring Only - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Randall Grove, PA is a Physician Assistant provider in Myrtle Beach, SC (NPI 1619969250).
Provider details
- NPI number
- 1619969250
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- MA001516L (PA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2005-08-19
- Last updated
- 2017-10-19
Frequently asked questions
- What is Randall Grove's NPI number?
- Randall Grove's National Provider Identifier (NPI) is 1619969250, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Randall Grove's specialty?
- Randall Grove is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Randall Grove located?
- Randall Grove's practice location on file with NPPES is 1101 Johnson Ave, Myrtle Beach, SC 29577-1893.
- What is Randall Grove's phone number?
- The practice phone number listed in the NPPES registry for Randall Grove is (843) 477-0177.
- Does Randall Grove accept Medicare?
- Randall Grove is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Randall Grove's NPI active?
- Yes — Randall Grove's NPI (1619969250) is active in the NPPES registry as of the last update on 2017-10-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.