Individual provider Active NPI

Randall C Edgell, MD

  • Neurology Physician
  • Saint Louis, MO
National Provider Identifier
1912097817
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036145444 Issued in IL
Practice address
1225 S Grand Blvd
Saint Louis, MO 63104-1016
Phone
(314) 977-4864
Fax
(314) 977-4878
NPI assigned
Oct 13, 2006
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036145444 IL Primary
Vascular Neurology Physician 2084V0102X 2007015340 MO
Vascular Neurology Physician 2084V0102X 036145444 IL

Addresses

Primary practice location

1225 S Grand Blvd
Saint Louis, MO 63104-1016

Mailing address

1008 S Spring Ave
Saint Louis, MO 63110-2520
Phone (314) 977-4864

Other practice location 1

301 N 8th St
Springfield, IL 62701-1041
Phone (217) 528-7541

Other practice location 2

3801 S National Ave
Springfield, MO 65807-5210
Phone (000) 000-0000

Other practice location 3

421 N 9th St
Springfield, IL 62702-5317
Phone (217) 757-6867

Other identifiers 1

IdentifierTypeStateIssuer
205461205MedicaidMO

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address redgell22320@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address redgell182800@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 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
I20070809000237 MO Practitioner - NeurologyPractitioner - NeurosurgeryPractitioner - Vascular SurgeryPractitioner - Interventional Radiology 6305876137 Reassigns benefits to 2 organizations
I20210724000021 IL Practitioner - NeurologyPractitioner - Other (Physician) 6305876137 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Interventional Radiology, Vascular Surgery
Education
Baylor College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

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

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

1225 S Grand Blvd
Saint Louis, MO 63104-1016

775 Engineering Ave
Springfield, IL 62703-5909
Phone (217) 522-4300

800 E Carpenter St
Springfield, IL 62702-5324
Phone (217) 544-6464

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82.25 of 100Reported as group
Quality
64.73
Promoting interoperability
100
Improvement activities
40
Cost
76.1

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036145444ILMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Neurology CurrentSince Jul 1, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Lester E Cox Medical Centers CurrentSince Jul 19, 2023 Accepting new patients
Springfield Clinic, LLP CurrentSince Jun 22, 2023 Accepting new patients
Osf Multi-Specialty Group CurrentSince Dec 23, 2025 Accepting new patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
SSM-Sluh Inc Past Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

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

1225 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-3390

1438 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 977-4828

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

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

8820 Manchester Rd
Saint Louis, MO 63144
Phone (314) 963-8100

1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

Interoperability endpoints

  • Direct secure messaging: redgell182800@ewd.direct.hshs.org
  • Direct secure messaging: redgell22320@direct-ehr-ssmhc.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1912097817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 S SPRING AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102520",
            "telephone_number": "314-977-4864",
            "fax_number": "314-977-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041016",
            "telephone_number": "314-977-4864",
            "fax_number": "314-977-4878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 N 8th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627011041",
            "country_code": "US",
            "telephone_number": "217-528-7541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 S National Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075210",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "421 N 9th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025317",
            "country_code": "US",
            "telephone_number": "217-757-6867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDGELL",
        "first_name": "RANDALL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036145444",
            "primary": true
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "MO",
            "license": "2007015340",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
            "license": "036145444",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205461205",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "redgell22320@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "redgell22320@direct-ehr-ssmhc.com",
            "address_1": "1225 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1225 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "redgell182800@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "421 N 9th St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627025317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.