Individual provider Active NPI

Randall K Gibb, MD

  • Gynecologic Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1639195944
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
102525 Issued in MO
Practice address
1031 Bellevue Ave Ste 400
Saint Louis, MO 63117-1858
Phone
(314) 977-7455
Fax
(314) 977-7477
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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 102525 MO Primary

Addresses

Primary practice location

1031 Bellevue Ave Ste 400
Saint Louis, MO 63117-1858

Mailing address

1031 Bellevue Ave Ste 400
Saint Louis, MO 63117-1858
Phone (314) 977-7455

Other identifiers 1

IdentifierTypeStateIssuer
076010217MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100903000175 MO Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 4486745494 Reassigns benefits to 2 organizations
I20260227000463 MD Practitioner - Gynecological Oncology 4486745494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological OncologyAlso: Obstetrics/Gynecology
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647

1031 Bellevue Ave
Suite 280a
Saint Louis, MO 63117-1818
Phone (314) 977-7455

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

2411 W Belvedere Ave
206 Sinai OB/GYN Assocates
Baltimore, MD 21215-5217
Phone (410) 601-9030

6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8208

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102525MOMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc. CurrentSince Feb 9, 2026 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Medical Group, Inc. CurrentSince May 2, 2022 Accepting new patients
Sinai Hospital of Baltimore Inc Gynecologic Oncology CurrentSince Feb 9, 2026 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM Medical Group Inc. CurrentSince May 2, 2022 Accepting new patients
Ozarks Medical Center Past Accepting new patients
SSM Medical Group Inc. Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

2411 W Belvedere Ave
Ste 2
Baltimore, MD 21215
Phone (410) 578-9030

2411 W Belvedere Ave
Ste 206
Baltimore, MD 21215
Phone (410) 578-9030

12277 De Paul Dr
Ste 100
Bridgeton, MO 63044
Phone (314) 209-4560

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

1031 Bellevue Ave
Ste 400
Saint Louis, MO 63117

Interoperability endpoints

  • Direct secure messaging: rgibb22434@direct-ehr-ssmhc.com

Organizations & group practices 10

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 3

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1639195944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 BELLEVUE AVE STE 400",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171858",
            "telephone_number": "314-977-7455",
            "fax_number": "314-977-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 BELLEVUE AVE STE 400",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171858",
            "telephone_number": "314-977-7455",
            "fax_number": "314-977-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBB",
        "first_name": "RANDALL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MO",
            "license": "102525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076010217",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.