Renny Beau Russell, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2008015663 Issued in MO

Practice address

6624 Royal St
Pleasant Valley, MO 64068-8711

Phone

(816) 824-9690

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Cleveland Chiropractic College - Kansas City, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Renny Russell DC PC

  • Chiropractor
  • Pleasant Valley, MO
  • NPI 1609019587
  Medicare reassignment NPD Authorized official
• Shoal Creek Chiropractic PC

  • Chiropractor
  • Kansas City, MO
  • NPI 1508992728
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1003905456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8009 NE 105TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641579100",
            "telephone_number": "816-824-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 ROYAL ST",
            "city": "PLEASANT VALLEY",
            "state": "MO",
            "postal_code": "640688711",
            "telephone_number": "816-824-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "RENNY",
        "middle_name": "BEAU",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3841",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2008015663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Teel Olson, LPC
• Renny Russell DC PC
• Christina Richmond, M.S. CCC-SLP
• Christina Kay Rohlfs, M. ED. & M. S.
• Andrea Ruse, PLPC
• Jada Sanders, RBT
• Haley Logan Smith, OTR/L
• Hadley Spainhower, RBT
• Lauren Rose Spittler, M.S.
• Shannon Henson Taylor, MA, CCC SLP

• Chiropractor in Pleasant Valley, MO
• Providers in Pleasant Valley, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.