NPIMap

Organization Active NPI

Eric G. Russell

Doing business as Beacon Chiropractic

  • Chiropractor
  • Commerce, TX
National Provider Identifier
1033320593
Registry record updated May 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9291 Issued in TX
Legal business name
ERIC G. RUSSELL
Doing business as
Beacon Chiropractic
Practice address
1205 Washington St
Commerce, TX 75428-2613
Phone
(903) 886-3100
Fax
(903) 886-3177
NPI assigned
May 25, 2007
Last updated
May 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2009

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

Authorized official

Name
Dr. Eric Glenn Russell, DCNPI 1336183904
Title
Doctor
Phone
(903) 886-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9291 TX Primary

Addresses

Primary practice location

1205 Washington St
Commerce, TX 75428-2613

Mailing address

1205 Washington St
Commerce, TX 75428-2613
Phone (903) 886-3100

Other identifiers 2

IdentifierTypeStateIssuer
1033320593OtherTXNPI
1336183904OtherTXNPI

Other names 1

  • Beacon Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

1205 Washington St
Commerce, TX 75428
Phone (903) 886-3100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243036800000",
    "number": "1033320593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 WASHINGTON ST",
            "city": "COMMERCE",
            "state": "TX",
            "postal_code": "754282613",
            "telephone_number": "903-886-3100",
            "fax_number": "903-886-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 WASHINGTON ST",
            "city": "COMMERCE",
            "state": "TX",
            "postal_code": "754282613",
            "telephone_number": "903-886-3100",
            "fax_number": "903-886-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC G. RUSSELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2009-05-23",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "903-886-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033320593",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1336183904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Commerce, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.