DR. RANDALL DEAN STALEY JR. MD
NPI 1295918449
Psychiatry & Neurology - Child & Adolescent Psychiatry in Springdale, AR

NPI Status: Active since December 11, 2007

Contact Information

4700 S THOMPSON ST STE C103
SPRINGDALE, AR
ZIP 72764
Phone: (479) 571-6363
Fax: (479) 684-3941

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  • Individual
  • Male
  • Years of Experience 21
  • Psychiatry & Neurology
  • Child & Adolescent Psychiatry
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About RANDALL STALEY

This page provides the complete NPI Profile along with additional information for Randall Staley, a provider established in Springdale, Arkansas with a medical specialization in Psychiatry & Neurology, focusing in child & adolescent psychiatry and more than 21 years of experience. He graduated from University Of Arkansas College Of Medicine in 2005. The healthcare provider is registered in the NPI registry with number 1295918449 assigned on December 2007. The practitioner's primary taxonomy code is 2084P0804X with license number E-6379 (AR). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1295918449
Provider Name
DR. RANDALL DEAN STALEY JR. MD
Gender
Male
Entity Type
Individual
Location Address
4700 S THOMPSON ST STE C103 SPRINGDALE, AR 72764
Location Phone
(479) 571-6363
Location Fax
(479) 684-3941
Mailing Address
PO BOX 1523 FAYETTEVILLE, AR 72702
Mailing Phone
(479) 571-6038
Mailing Fax
(479) 684-3941
Medical School Name
UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduation Year
2005
Is Sole Proprietor?
No
Enumeration Date
12-11-2007
Last Update Date
08-15-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatry & Neurology Child & Adolescent Psychiatry

Taxonomy Code
2084P0804X
Type
Allopathic & Osteopathic Physicians
License No.
E-6379
License State
AR
Taxonomy Description
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12084P0800XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Psychiatry

E-6379 (AR)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Complete Silver (QualChoice) - POS
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Everyday Silver (QualChoiceLife) - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Premier Silver - EPO
  • Premier Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Standard Gold - PPO
  • Standard Gold + Vision + Adult Dental - PPO
  • Standard Silver - PPO
  • Clear Silver - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Bronze Exp Standardized - PPO
  • Bronze Value - PPO
  • Gold Standardized - PPO
  • Silver AH - PPO
  • Silver Standardized - PPO
  • Silver Value - PPO
  • Dental Gold - PPO
  • Dental Gold Plus Vision - PPO
  • Dental Pediatric - PPO
  • Dental Platinum - PPO
  • Dental Platinum Plus Vision - PPO
  • Dental Platinum Premium - PPO
  • Dental Platinum Premium Plus Vision - PPO
  • Dental Silver - PPO
  • HA Bronze Exp Standardized - POS
  • HA Bronze Suitcase - POS
  • HA Gold Standardized - POS
  • HA Silver AH - POS
  • HA Silver Premier Suitcase - POS
  • HA Silver Standardized - POS
  • Octave Bronze Exp Standardized - POS
  • Octave Bronze Value - POS
  • Octave Gold Standardized - POS
  • Octave Silver AH - POS
  • Octave Silver Classic Suitcase - POS
  • Octave Silver Standardized - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
E6379OTHER (01)ARSTATE LICENSE

Medicare Participation & PECOS Enrollment Status

Randall Staley is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Randall Staley is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 5193982908

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20120207000316

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 72 times for 44 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 142 times for 56 patients

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1295918449
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221851811648
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 8 + 5 + 1 + 8 + 1 + 1 + 6 + 4 + 8 + 24 = 71
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 71 = 99

The NPI number 1295918449 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1295194132 BRITTANY S SEIFERT
Individual
Nurse Practitioner (Psychiatric/Mental Health)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363
1770720500 ANDREA COLE LPC, LAMFT
Individual
Counselor (Professional)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363
1215562459 NICHOLAS W HOPKINS APRN
Individual
Nurse Practitioner (Psychiatric/Mental Health)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363
1467084384MS. LAURA L WILLIAMS APRN
Individual
Nurse Practitioner (Psychiatric/Mental Health)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363
1063947604MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS PA
Organization
Counselor (Professional)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363
1538668926MEDICAL ASSOCIATES OF NORTHWEST ARKANSAS PA
Organization
Psychiatry & Neurology (Psychiatry)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363
1891740502 LANCE C FOSTER MD
Individual
Psychiatry & Neurology (Psychiatry)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363
1689397952 JULIE LYNNE BROOKS APRN
Individual
Nurse Practitioner (Psychiatric/Mental Health)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363
1275388795 GRANT MICHAEL BARNETT MNSC, APRN, PMHNP-BC
Individual
Nurse Practitioner (Psychiatric/Mental Health)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363
1235757816 KYLE C SIEROCUK APRN
Individual
Nurse Practitioner (Psychiatric/Mental Health)4700 S THOMPSON ST STE C103
SPRINGDALE, AR 72764
(479) 571-6363

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295918449, enumerated in the NPI registry as an "individual" on December 11, 2007

The provider is located at 4700 S Thompson St Ste C103 Springdale, Ar 72764 and the phone number is (479) 571-6363

The provider's speciality is Psychiatry & Neurology with taxonomy code 2084P0804X with a focus in Child & Adolescent Psychiatry

The provider has more than 21 years of experience. He graduated from University Of Arkansas College Of Medicine in 2005.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes and Established patient office or other outpatient visit, 30-39 minutes.

This NPI record was last updated on December 11, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.