Individual provider Active NPI

Ryan Nelson Russell, DC

  • Chiropractor
  • Hoover, AL
National Provider Identifier
1063889848
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2449 Issued in AL
Practice address
1580 Montgomery Hwy
Suite 14
Hoover, AL 35216-4586
Phone
(205) 637-1363
Fax
(205) 637-1391
NPI assigned
Aug 27, 2015
Last updated
Feb 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2449 AL Primary

Addresses

Primary practice location

1580 Montgomery Hwy
Suite 14
Hoover, AL 35216-4586

Mailing address

1580 Montgomery Hwy
Suite 14
Hoover, AL 35216-4586
Phone (205) 637-1363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1063889848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 MONTGOMERY HWY",
            "address_2": "SUITE 14",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352164586",
            "telephone_number": "205-637-1363",
            "fax_number": "205-637-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 MONTGOMERY HWY",
            "address_2": "SUITE 14",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352164586",
            "telephone_number": "205-637-1363",
            "fax_number": "205-637-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "RYAN",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.