Robert Alan Russell, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X2707C Issued in NY

Practice address

25 East Broad Street
Mount Vernon, NY 10552

Phone

(914) 699-6770

Fax

(914) 664-0090

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fleetwood Chiropractic PC

  • Chiropractor
  • Mount Vernon, NY
  • NPI 1821282930
  NPD (past) Authorized official

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104850684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 EAST BROAD STREET",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "10552",
            "telephone_number": "914-699-6770",
            "fax_number": "914-664-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 EAST BROAD STREET",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "10552",
            "telephone_number": "914-699-6770",
            "fax_number": "914-664-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X2707C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatyana Rudakova, RN
• Amanda Rudolph, RN, LPN
• Laurie Ann Ruffin, COTA/L
• Danielle A Ruocco, D.D.S.
• Audria Ann-Marie Russell
• Rosemarie Russell, FNP
• Warren Russell
• Angela Russo
• Rvohrx, LLC
• S&a Drug Store Inc

• Chiropractor in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.