Individual provider Active NPI

Randall D Hightower, MD

  • Gynecologic Oncology Physician
  • Fayetteville, AR
National Provider Identifier
1235189069
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
C6621 Issued in AR
Practice address
3215 N Northhills Blvd
Suite B
Fayetteville, AR 72703-4424
Phone
(479) 463-5500
Fax
(479) 463-5542
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X C6621 AR Primary

Addresses

Primary practice location

3215 N Northhills Blvd
Suite B
Fayetteville, AR 72703-4424

Mailing address

3215 N Northhills Blvd
Suite B
Fayetteville, AR 72703-4424
Phone (479) 463-5500

Other identifiers 2

IdentifierTypeStateIssuer
5K688OtherARBLUE
143972001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050803000514 AR Practitioner - Obstetrics/GynecologyPractitioner - Gynecological Oncology 4789612383 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince Jul 1, 2009 Accepting new patients
Washington Regional Medical System CurrentSince Jul 1, 2009 Accepting new patients

Locations

3215 N Northhills Blvd
Ste B
Fayetteville, AR 72703
Phone (479) 463-1000

3276 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 442-7030

813 Founders Park Dr W
Ste 201
Springdale, AR 72762
Phone (479) 463-5500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1235189069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 N NORTHHILLS BLVD",
            "address_2": "SUITE B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034424",
            "telephone_number": "479-463-5500",
            "fax_number": "479-463-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N NORTHHILLS BLVD",
            "address_2": "SUITE B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034424",
            "telephone_number": "479-463-5500",
            "fax_number": "479-463-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGHTOWER",
        "first_name": "RANDALL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "AR",
            "license": "C6621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE",
            "identifier": "5K688",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143972001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.