T. Jeff Russell, M.D., P.a

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

T. JEFF RUSSELL, M.D., P.A

Practice address

2801 Lemmon Ave West
Suite 310
Dallas, TX 75204

Phone

(214) 522-2661

Fax

(214) 522-5469

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Kimberly Kitcher

Title

Credentialing

Phone

(214) 522-2661

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Slayton William Ebeling, O.D.

  • Optometrist
  • Dallas, TX
  • NPI 1629459862
  Medicare reassignment Care Compare group NPD
• Thomas Jeffrey Russell, M.D.

  • Ophthalmology Physician
  • Dallas, TX
  • NPI 1770539967
  Medicare reassignment Care Compare group NPD
• Justin Michael Wileman, DO

  • Cornea and External Diseases Specialist Physician
  • Dallas, TX
  • NPI 1003310509

  Ophthalmology

  Medicare reassignment Care Compare group NPD
• Heather H. Winslow, MD

  • Ophthalmology Physician
  • Dallas, TX
  • NPI 1669675633
  Medicare reassignment Care Compare group NPD
• Nicola Kim, MD

  • Ophthalmology Physician
  • Little Rock, AR
  • NPI 1194815688
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1063534758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 LEMMON AVE WEST",
            "address_2": "SUITE 310",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75204",
            "telephone_number": "214-522-2661",
            "fax_number": "214-522-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 LEMMON AVE WEST",
            "address_2": "SUITE 310",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75204",
            "telephone_number": "214-522-2661",
            "fax_number": "214-522-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T. JEFF RUSSELL, M.D., P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "KITCHER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "214-522-2661"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180041912",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144819301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.