Active NPI
Randall Benjamin Oates, M.D.
- Family Medicine Physician
- Fayetteville, AR
National Provider Identifier
1215067822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C-5922
- Practice address
- 4220 N.Crossoverrd
Fayetteville, AR 70703 - Phone
- (479) 251-1552
- Fax
- (479) 251-8956
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C-5922 | AR | Primary |
Addresses
Primary practice location
4220 N.Crossoverrd
Fayetteville, AR 70703
Mailing address
4220 N.Crossoverrd
Fayetteville, AR 70703
Phone (479) 251-1552
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C-5922 | Other | AR | ARK STATE MEDICAL BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-5922 | AR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215067822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4220 N.CROSSOVERRD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "70703",
"telephone_number": "479-251-1552",
"fax_number": "479-251-8956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 N.CROSSOVERRD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "70703",
"telephone_number": "479-251-1552",
"fax_number": "479-251-8956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OATES",
"first_name": "RANDALL",
"middle_name": "BENJAMIN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "C-5922",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARK STATE MEDICAL BOARD",
"identifier": "C-5922",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.