Elizabeth B Russell, MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

35138914 Issued in OH

Practice address

885 N Sandusky Ave
Upper Sandusky, OH 43351-1098

Phone

(419) 294-4991

Fax

(419) 294-4750

NPI assigned

May 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Froedtert South, Inc.

  • Family Medicine Physician
  • Kenosha, WI
  • NPI 1558305284
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1093767774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 N SANDUSKY AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511098",
            "telephone_number": "262-515-3040",
            "fax_number": "419-209-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 N SANDUSKY AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511098",
            "telephone_number": "419-294-4991",
            "fax_number": "419-294-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ELIZABETH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "27065",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AR",
            "license": "E-6331",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OH",
            "license": "35138914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30686300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN S.E MEDICAID",
            "identifier": "81018",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS COMM. HEALTH",
            "identifier": "81018",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIAMOND PROVIDER ID",
            "identifier": "1058858001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0394617",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shileigh Erin Ricker, STNA
• Teena M Rife, RN
• Tamera Joan Risner, STNA
• Rowan Ritchey, MS, AT, ATC
• Mary E Roszman, LPN
• George J Sakash, LICDC, LPC
• Lana C. Sakash, LISW
• Sarah Frey
• Peter Joseph Schuler, MD
• Abby Gayle Searfoss, CNP

• Rheumatology Physician in Upper Sandusky, OH
• Providers in Upper Sandusky, OH by specialty
• Rheumatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.