GANNON B RANDOLPH M.D.
NPI 1528173697
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Bentonville, AR

Q: What is Gannon Randolph's NPI number?

The NPI number for Gannon Randolph is 1528173697. It was assigned to this individual provider in the NPPES registry on August 20, 2006.

Q: What is Gannon Randolph's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Surgery of the Spine, with taxonomy code 207XS0117X.

Q: When was this NPI record last updated?

The NPPES record for Gannon Randolph was last updated on July 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 20, 2006PECOS EnrolledAccepts Medicare Assignment

1800 SE MOBERLY LN, BENTONVILLE, AR 72712(479) 521-2752(479) 521-4603 Get Directions Write a Review

NPPES record last updated: July 12, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 12, 2021, Apr 15, 2020 (2 updates tracked since 2020).

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About Gannon B Randolph M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GANNON B RANDOLPH M.D. (NPI 1528173697) is an individual orthopaedic surgery of the spine provider in Bentonville, Arkansas, licensed in Arkansas (E5957) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Oregon Health Sciences University School Of Medicine (2000).

NPPES Registry Identity

NPI1528173697

Entity TypeIndividualMale

Primary Taxonomy207XS0117X

Provider Legal NameGANNON B RANDOLPHCredential: M.D.

Location Address1800 SE MOBERLY LNBentonville, AR 72712-7017

Mailing Address3317 N Wimberly DrFayetteville, AR 72703-4056 · (479) 521-2752 · Fax (479) 521-4603

Phone(479) 521-2752

Fax(479) 521-4603

Sole ProprietorNo

Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2000

Enumeration DateAugust 20, 2006

Last NPPES UpdateJuly 12, 20212 updates tracked since enumeration

NPPES CertifiedJuly 12, 2021

✔ NPI 1528173697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic Surgery of the SpineAllopathic & Osteopathic Physicians

Taxonomy Code207XS0117X

License✔ Licensed in AR · E5957

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License E5957 (AR)

1800 SE MOBERLY LN, Bentonville, AR 72712

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Other Identifiers 1

Medicaid1176259001AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gannon B Randolph M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941230619

PECOS Enrollment IDI20090327000295

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

247 services174 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

176 services130 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

93 services93 patients

X-ray of upper spine, 2-3 views 72040

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

76 services48 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

64 services62 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

54 services46 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

37 services37 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

31 services31 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

27 services14 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

25 services19 patients

Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment 63048

This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.

18 services17 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

15 services14 patients

Injection of trigger points, 1-2 muscles 20552

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. 1-2 muscles are typically treated in one session. The procedure involves injecting medications into these points to alleviate pain.

14 services11 patients

Placement of stabilizing device to back of 1 spine bone in neck 22840

This procedure involves positioning a stabilizing device onto a single spinal bone in the neck. The goal is to provide support and prevent movement that could cause discomfort or further injury. It's performed by trained specialists under anesthesia.

14 services13 patients

Fusion of spine in lower back with partial removal of spine bone and disc 22633

This procedure, called lumbar spinal fusion, involves joining two or more vertebrae in your lower back. It includes a partial removal of a spine bone and disc to alleviate pain and improve stability. The goal is to reduce motion between vertebrae and prevent nerve irritation.

12 services12 patients

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Osteogenesis stimulator, electrical, non-invasive, spinal applications E0748

DME-Other DME · category DE000N

1 supplier18 claims18 services$3,761.48 avg. paid by Medicare

Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf L0174

DME-Orthotic Devices · category DF000N

2 suppliers13 claims13 services$220.23 avg. paid by Medicare

Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf L0642

DME-Orthotic Devices · category DF007N

2 suppliers26 claims26 services$254.15 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REAGAN ELIZABETH HUETT

Physician Assistant

1800 SE MOBERLY LN
BENTONVILLE, AR 72712

Benton County (479) 521-2752

OZARK ORTHOPAEDICS, P.A.

Orthopaedic Surgery

1800 SE MOBERLY LN, STE B
BENTONVILLE, AR 72712

Benton County (479) 521-2752

BROOKE NICOLE WARREN PT

Physical Therapist

1800 SE MOBERLY LN
BENTONVILLE, AR 72712

Benton County (479) 715-6330

LAURA HADLEY BUERGLER DPT

Physical Therapist

1800 SE MOBERLY LN
BENTONVILLE, AR 72712

Benton County (479) 715-6330

KAITLYN NICOLE EASTMAN JONES PT, DPT

Physical Therapist

1800 SE MOBERLY LN
BENTONVILLE, AR 72712

Benton County (479) 715-6600

DR. ROBERT ANGUS MACLEOD M.D.

Orthopaedic Surgery (Sports Medicine)

1800 SE MOBERLY LN, STE 4
BENTONVILLE, AR 72712

Benton County (479) 715-6600

ANTHONY ADAIR DPT

Physical Therapist

1800 SE MOBERLY LN
BENTONVILLE, AR 72712

Benton County (479) 715-6330

SAMUEL LOGAN PATTON MD

Anesthesiology (Pain Medicine)

1800 SE MOBERLY LN
BENTONVILLE, AR 72712

Benton County (479) 521-2752

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gannon Randolph's NPI number?

The NPI number for Gannon Randolph is 1528173697. It was assigned to this individual provider in the NPPES registry on August 20, 2006.

Where is Gannon Randolph located?

Gannon Randolph practices at 1800 SE Moberly Ln, Bentonville, AR 72712. The listed phone number is (479) 521-2752.

What is Gannon Randolph's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Surgery of the Spine, with taxonomy code 207XS0117X.

Is Gannon Randolph enrolled in Medicare?

Yes. Gannon Randolph is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Gannon Randolph accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 5 other insurers list Gannon Randolph as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gannon Randolph was last updated on July 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.