Russell Shults, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

042-0014896 Issued in VT

Practice address

111 Colchester Ave
Burlington, VT 05401-1473

Phone

(802) 847-0000

NPI assigned

May 9, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Anesthesiology

Education

University of Vermont College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Physicians Network PLLCGroup PAC ID 5496029407, 218 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospital Hospital, San Antonio, TX, CCN 450388

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rshults132623@direct.uvmhealth.org

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.

• Independent Physicians Network PLLC

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1396274676
  Medicare reassignment Care Compare group NPD
• Golden State Providers, a Medical Corporation

  • Multi-Specialty Clinic/Center
  • Moorpark, CA
  • NPI 1366859449
  Medicare reassignment NPD
• Pediatric Dentistry of Keller PLLC

  • Pediatric Dentistry
  • Keller, TX
  • NPI 1750934253
  NPD (past)

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

• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1124074273
  Care Compare affiliation
• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1689627655
  Care Compare affiliation
• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1952348021
  Care Compare affiliation

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1083060073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MOORLAND DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044424",
            "telephone_number": "865-322-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTS",
        "first_name": "RUSSELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VT",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VT",
            "license": "042-0014896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan R Ship, MD
• Cheryl Shive, MS, MSW, LICSW
• Lauren Wendall Shores, PSYD
• Genevive Shortt
• Tisha Mesa Shull, M.A.
• Chloe Nicole Sickles
• Nikoletta Sidiropoulos, M.D.
• Amy Siegel, M.S.W.
• Heather Sienkiewicz
• Vaia Sigounas, M.D.

• Anesthesiology Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Anesthesiology Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.