NPIMap

Individual provider Active NPI

John R Russell, D.O.

  • Internal Medicine Physician
  • Kansas City, MO
National Provider Identifier
1063486660
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36959 Issued in MO
Practice address
6080 N Oak Trfy
Kansas City, MO 64118-5158
Phone
(816) 453-9232
Fax
(816) 455-2423
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36959 MO Primary

Addresses

Primary practice location

6080 N Oak Trfy
Kansas City, MO 64118-5158

Mailing address

2700 Clay Edwards Dr
Suite 240
North Kansas City, MO 64116-3251
Phone (816) 691-5287

Other identifiers 2

IdentifierTypeStateIssuer
1063486660MedicaidMO
243649753MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040415001032 MO Practitioner - Internal Medicine 8022002278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
R Franklin University of Med & Sci/Chicago Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1705 Christy Dr
Suite 100
Jefferson City, MO 65101-5195
Phone (573) 635-7022

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
The Curators of the University of Missouri CurrentSince Jan 1, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Landmark Medical Center, Inc. Past Accepting new patients
Meritas Health Corporation Past Accepting new patients
Meritas Health Corporation Past Accepting new patients
Midwest Hospital Specialists, P.a. Internal Medicine Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1705 Christy Dr
Ste 100
Jefferson Cty, MO 65101
Phone (573) 635-7022

1125 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5000

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1063486660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 CLAY EDWARDS DR",
            "address_2": "SUITE 240",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163251",
            "telephone_number": "816-691-5287",
            "fax_number": "816-346-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 N OAK TRFY",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641185158",
            "telephone_number": "816-453-9232",
            "fax_number": "816-455-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "36959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063486660",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243649753",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.