John J Russell, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

100521 Issued in MO

Practice address

1610 N Kings Highway St
Suite 304
Cape Girardeau, MO 63701-2196

Phone

(573) 335-2191

Fax

(573) 335-5524

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

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

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.

• Cape Girardeau County Health Department

  • State or Local Public Health Clinic/Center
  • Cape Girardeau, MO
  • NPI 1477538825
  NPD (past)
• Cape Girardeau County Health Department

  • Rural Health Clinic/Center
  • Cape Girardeau, MO
  • NPI 1831174762
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1124098728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 N KINGS HIGHWAY ST",
            "address_2": "SUITE 304",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012196",
            "telephone_number": "573-335-2191",
            "fax_number": "573-335-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 N KINGS HIGHWAY ST",
            "address_2": "SUITE 304",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012196",
            "telephone_number": "573-335-2191",
            "fax_number": "573-335-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "100521",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "100521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "178739",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "125591",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203340815",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "370018381",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruopp and Ruopp DDS PC
• Jack Richard Ruopp, D.C.
• Janet Brunton Ruopp, D.D.S
• Patrick Robert Ruopp, D.D.S.
• Christopher Thomas Russell, MD
• Robert Blaine Russell, D.O.
• Saylor B Russell, PTA
• Martha Kickasola Rusten
• S & R Anesthesia Services Inc
• Robert F. Sacha, D. O.

• All providers in Cape Girardeau, MO
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.