Randall Wayne Black, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

C7458 Issued in AR

Practice address

5204 W Redbud Street
Rogers, AR 72758

Phone

(479) 636-0110

Fax

(479) 631-0491

NPI assigned

May 1, 2006

Last updated

Jul 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Otolaryngology

Education

University of Arkansas College of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, shared by 5 NPIs, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
• Mercy Hospital Berryville Hospital, Berryville, AR, CCN 041329

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rblack17278@directc.mercy.net

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.

• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  Medicare reassignment NPD
• Mercy Health Northwest Arkansas Communities

  • Otolaryngology Physician
  • Rogers, AR
  • NPI 1508167677
  Medicare reassignment NPD
• Mercy Health Northwest Arkansas Communities

  • Orthopaedic Surgery Physician
  • Rogers, AR
  • NPI 1063835908
  NPD
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1770087371
  NPD

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

• Mercy Hospital Berryville

  • Critical Access Hospital
  • Berryville, AR
  • NPI 1457306326
  Care Compare affiliation
• Mercy Hospital Rogers

  dba Mercy Hospital Northwest Arkansas

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1942268909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 W REDBUD STREET",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-636-0110",
            "fax_number": "479-631-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 W REDBUD STREET",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-636-0110",
            "fax_number": "479-631-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "RANDALL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AR",
            "license": "C7458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke A Bisbee, DPM
• Rachel Bishop
• Lainey Elizabeth Bivin
• Austin J Black, CRNA
• Marcus D Black, D.D.S.
• Reece Black, DPT
• Susan Ann Black, OTR/L
• Teagan Elise Blackston
• Megan Bladow
• David Blair

• Otolaryngology Physician in Rogers, AR
• Providers in Rogers, AR by specialty
• Otolaryngology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.