Individual provider Active NPI

Gollsheed Ouranos, MD

  • Family Medicine Physician
  • Russellville, AR
National Provider Identifier
1700589082
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-20710 Issued in AR
Practice address
1808 W Main St Ste 304
Russellville, AR 72801-2724
Phone
(479) 968-2841
NPI assigned
Mar 24, 2023
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-20710 AR Primary

Addresses

Primary practice location

1808 W Main St Ste 304
Russellville, AR 72801-2724

Mailing address

5 Medical Park Dr Ste 304
Benton, AR 72015-3745
Phone (501) 408-2429

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
I20230707000715 AR Order and Referring Only - Family PracticePractitioner - Family Practice 2466811534

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5 Medical Park Dr
Suite 304
Benton, AR 72015-3730

5308 Ellington CT
Newburgh, IN 47630-3162

612 S 12TH St
Fort Smith, AR 72901-3892

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1700589082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PARK DR STE 304",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153745",
            "telephone_number": "501-408-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 W MAIN ST STE 304",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012724",
            "telephone_number": "479-968-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OURANOS",
        "first_name": "GOLLSHEED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-20710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.