NPIMap

Individual provider Active NPI

Gautam Kanu Gandhi, M.D., PH.D.

  • Neurological Surgery Physician
  • Little Rock, AR
National Provider Identifier
1558505172
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
E9614 Issued in AR
Practice address
108 N Shackleford Rd Ste 108
Little Rock, AR 72211-2840
Phone
(501) 234-0600
Fax
(501) 232-3409
NPI assigned
Apr 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X E9614 AR Primary

Addresses

Primary practice location

108 N Shackleford Rd Ste 108
Little Rock, AR 72211-2840

Mailing address

17200 Chenal Pkwy Ste 300-303
Little Rock, AR 72223-5958
Phone (501) 234-0600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160706002638 AR Practitioner - Neurosurgery 0840516647 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

108 N Shackleford Rd
Suite 108
Little Rock, AR 72211-2840
Phone (501) 234-0600

815 Hogan LN
Suite 5
Conway, AR 72034-7960
Phone (501) 224-0200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion197
Laminectomy or laminotomy (partial removal of spine bones)63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E9614ARMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Spine and Neurosurgery PLLC Neurological Surgery CurrentSince Dec 5, 2024 Accepting new patients
Arkansas Health Group CurrentSince Jul 5, 2016 Accepting new patients
Pain Treatment Centers of America PLLC CurrentSince Jan 1, 2023 Accepting new patients
Pain Treatment Centers of America, PLLC CurrentSince Jan 1, 2023 Accepting new patients
Arkansas Health Group Neurological Surgery CurrentSince Jul 5, 2016 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Hot Springs Ambulatory Surgery Center, LLC Past Accepting new patients

Locations

1215 Sidney St
Batesville, AR 72501
Phone (870) 262-1541

815 Hogan Ln
Ste 5
Conway, AR 72034
Phone (501) 329-1888

148 Sawtooth Oak St
Hot Springs National Park, AR 71901
Phone (501) 346-8116

17200 Chenal Pkwy
Ste 300303
Little Rock, AR 72223

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

108 N Shackleford Rd
Ste 108
Little Rock, AR 72211
Phone (501) 234-0600

4020 Richards Rd
Ste A
North Little Rock, AR 72117
Phone (501) 900-8763

Interoperability endpoints

  • Direct secure messaging: ggandhi148093@direct.baptist-healthar.org
  • Direct secure messaging: ggandhi@pinnaclespine.emadirect.md

Organizations & group practices 7

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1558505172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 CHENAL PKWY STE 300-303",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722235958",
            "telephone_number": "501-234-0600",
            "fax_number": "501-232-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N SHACKLEFORD RD STE 108",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112840",
            "telephone_number": "501-234-0600",
            "fax_number": "501-232-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "GAUTAM",
        "middle_name": "KANU",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-27",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AR",
            "license": "E9614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.