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DR. RANDALL DEAN STALEY MD NPI 1295918449


NPI Information

NPI: 1295918449
Provider Name: DR. RANDALL DEAN STALEY, MD
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

PECOS Registration: Yes

Address:
4700 S THOMPSON ST STE C103
SPRINGDALE, AR
ZIP 72764
Phone: (479) 571-6363
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DR. Randall Dean Staley, MD is a child and adolescent psychiatry psychiatry neurology in Springdale, AR with 19 years of experience. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. DR. Randall Dean Staley, MD NPI is 1295918449. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduation Year:2005

The provider's business location address is:

4700 S THOMPSON ST STE C103
SPRINGDALE, AR
ZIP 72764
Phone: (479) 571-6363
Fax: (479) 684-3941

The NPI 1295918449 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychiatric diagnostic evaluation with medical services (HCPCS:90792)

The enumeration date for this NPI number is 12/11/2007 and was last updated on 1/22/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0800XPsychiatry & NeurologyPsychiatryE-6379ARKANSASNo
22084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryE-6379ARKANSASYes
3208000000XPediatricsE-6379ARKANSASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E6379OTHERARKANSASSTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.