Individual provider Active NPI

Calyn Cheyenne Russ

  • Audiologist
  • Shawnee, OK
National Provider Identifier
1013381565
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
3954 N Kickapoo Ave
Shawnee, OK 74804-1698
Phone
(405) 273-6203
NPI assigned
Nov 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

3954 N Kickapoo Ave
Shawnee, OK 74804-1698

Mailing address

3954 N Kickapoo Ave
Shawnee, OK 74804-1698
Phone (405) 273-6203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161104000318 OK Practitioner - Qualified Audiologist 3870871379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hearuss LLCGroup PAC ID 3072050079, 2 clinicians

Practice addresses (Care Compare)

3954 N Kickapoo Ave
Suite 5
Shawnee, OK 74804-1635
Phone (405) 273-6203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5093OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hearuss LLC Audiologist CurrentSince May 27, 2024 Accepting new patients
Audiology of Tulsa Inc Audiologist PastSince Jul 1, 2016 Accepting new patients
ENT & Allergy Associates, P.C. PastSince Aug 5, 2018 Accepting new patients

Locations

3954 N Kickapoo Ave
Shawnee, OK 74804
Phone (405) 273-6203

3954 N Kickapoo Ave
Ste 5
Shawnee, OK 74804
Phone (405) 273-6203

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/15dd2bda-9d00-4c3d-967c-f374acf8d6ab/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1013381565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3954 N KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041698",
            "telephone_number": "405-273-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3954 N KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041698",
            "telephone_number": "405-273-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "CALYN",
        "middle_name": "CHEYENNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.