DR. RANDALL DEAN STALEY JR. (NPI# 1295918449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295918449 |
| Entity Type | Individual |
| Full Name | DR. RANDALL DEAN STALEY JR. |
| Credential | MD |
| Practice Address |
4700 S Thompson St Ste C103 Springdale AR 72764 |
| Mailing Address |
Po Box 1523 Fayetteville AR 72702-1523 |
| Practice Telephone | 4795716363 |
| Practice Fax Number | 4796843941 |
| Mailing Telephone | 4795716038 |
| Mailing Fax Number | 4795820222 |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2018-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | E-6379 | AR | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
E-6379 | AR | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
E-6379 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | STATE LICENSE | E6379 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2400 S 48th St, Springdale, AR 727626683 | 4797502020 | 4797508967 |
| 4253 N Crossover Rd, Fayetteville, AR 72703 | 4795215731 |
| Street Address |
4700 S THOMPSON ST STE C103 |
| City | SPRINGDALE |
| State | AR |
| Zip Code | 72764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891740502 | Lance C Foster | Psychiatry & Neurology | 4700 S Thompson St Ste C103, Springdale, AR 72764-2558 | 2006-05-23 |
| 1215562459 | Nicholas W Hopkins | Nurse Practitioner | 4700 S Thompson St Ste C103, Springdale, AR 72764-2558 | 2020-03-09 |
| 1538668926 | Medical Associates of Northwest Arkansas Pa | Psychiatry & Neurology | 4700 S Thompson St Ste C103, Springdale, AR 72764-2558 | 2018-02-12 |
| 1063947604 | Medical Associates of Northwest Arkansas Pa | Psychiatry & Neurology | 4700 S Thompson St Ste C103, Springdale, AR 72764-2558 | 2017-04-20 |
| 1295194132 | Brittany S Seifert | Nurse Practitioner | 4700 S Thompson St Ste C103, Springdale, AR 72764 | 2016-02-21 |
| 1770720500 | Andrea Cole | Counselor | 4700 S Thompson St Ste C103, Springdale, AR 72764 | 2009-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851903884 | Conway County Community Service Inc. | Community/Behavioral Health | 616 E. Emma Avenue, Suite 244, Springdale, AR 72764 | 2020-08-20 |
| 1316592801 | Above and Beyond Pediatric Therapy, Inc | Speech-Language Pathologist | 2700 American St., Ste B, Springdale, AR 72764 | 2019-08-02 |
| 1053871061 | Specialized Hearing Instruments, Inc. | Audiologist-Hearing Aid Fitter | 958 S. West End St., Springdale, AR 72764 | 2019-03-25 |
| 1801385976 | Taylor Beauregard Kelamis | Nurse Practitioner | Mercy Clinic Family Medicine, 1110 W. Robinson Ave, Springdale, AR 72764 | 2018-05-04 |
| 1649726878 | Ember Estelle Lanuti Brown | Speech-Language Pathologist | 4209 Navajo Court, Springdale, AR 72764 | 2016-08-28 |
| 1568838241 | Elayna Wells | Speech-Language Pathologist | 900 S Powell Street, Springdale, AR 72764 | 2015-08-17 |
| 1184003261 | Okeyo Oghina | Nurse Practitioner | 609 West Maple Avenue, Northwest Health System, Springdale, AR 72764 | 2015-05-22 |
| 1235524869 | William M Rogers | Family Medicine | 513 N. Shiloh Street, Springdale, AR 72764 | 2015-03-31 |
| 1336498872 | Kelly Meeann Miller | Speech-Language Pathologist | 105 S Blair Street, Springdale, AR 72764 | 2012-08-30 |
| 1902183874 | Cristy Hoffman | Physical Therapy Assistant | 2837 American St Ste A, Springdale, AR 72764 | 2011-11-07 |
| Find all providers in zip 72764 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| 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. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285189290 | John C. Leach, Md Pllc | Psychiatry & Neurology | 75 Wellington Colony Dr, Little Rock, AR 72211-2089 | 2016-08-19 |
| 1326350885 | Nihit Kumar | Psychiatry & Neurology | 4301 W Markham St # 589, Little Rock, AR 72205-7101 | 2010-07-12 |
| 1457679011 | Kelsey L.m. Mcclellan | Psychiatry & Neurology | 124 W Capitol Ave, Suite 1900, Little Rock, AR 72201-3704 | 2010-05-06 |
| 1043331010 | Samuel Tyler Armstrong Bayles | Psychiatry & Neurology | 700 S Schiller St, Little Rock, AR 72201-4735 | 2007-04-03 |
| 1548381510 | Kathryn A Panek | Psychiatry & Neurology | 74 W Sunbridge Dr, Suite 1, Fayetteville, AR 72703-1822 | 2007-04-03 |
| 1417082710 | Roger Lew Hiatt Jr. | Psychiatry & Neurology | 600 N 7th St, West Memphis, AR 72301-3235 | 2007-02-23 |
| 1467528026 | University of Arkansas for Medical Sciences | Psychiatry & Neurology | 11 Childrens Way # 854, Little Rock, AR 72202 | 2006-11-27 |
| 1801999289 | Thomas W Freeman | Psychiatry & Neurology | 3604 Central Avenue, Suite C, Hot Springs, AR 71913 | 2006-09-07 |
| 1689617417 | Norman I Snyder | Psychiatry & Neurology | 4253 N Crossover Rd, Suite 2, Fayetteville, AR 72703-4593 | 2006-06-13 |
| 1154370518 | Zarina Shah | Psychiatry & Neurology | 5905 Forest Pl, Centers for Youth and Families, Suite 210, Little Rock, AR 72207-5245 | 2006-05-10 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGDALE |
| Zip Code | 72764 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.