Individual provider Active NPI

Courtney Dawn Ranallo, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Little Rock, AR
National Provider Identifier
1487863759
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
800 Marshall St
Slot 512-19a
Little Rock, AR 72202-3510
Phone
(501) 364-3196
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

800 Marshall St
Slot 512-19a
Little Rock, AR 72202-3510

Mailing address

10005 Kane Dr
Little Rock, AR 72211
Phone (405) 370-9515

Other names 1

  • Courtney Dawn Wallace Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20130828000817 OK Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 8325281058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
53.73
Promoting interoperability
100
Improvement activities
40
Cost
70.48

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Aug 12, 2013 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Aug 12, 2013 Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

1200 Everett Dr
#8
Oklahoma City, OK 73104
Phone (405) 271-5211

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Interoperability endpoints

  • Direct secure messaging: cranallo29725@ouhealth.direct-ci.net

Organizations & group practices 5

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487863759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10005 KANE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72211",
            "telephone_number": "405-370-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MARSHALL ST",
            "address_2": "SLOT 512-19A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANALLO",
        "first_name": "COURTNEY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "WALLACE",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.