Active NPI
Richard Keith Russell, PH.D
- Cognitive & Behavioral Psychologist
- Worthington, OH
National Provider Identifier
1124236302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 2141
- Practice address
- 450 W Wilson Bridge Rd
Suite 350
Worthington, OH 43085-2237 - Phone
- (614) 436-6080
- NPI assigned
- May 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 2141 | OH | Primary |
Addresses
Primary practice location
450 W Wilson Bridge Rd
Suite 350
Worthington, OH 43085-2237
Mailing address
450 W Wilson Bridge Rd
Suite 350
Worthington, OH 43085-2237
Phone (614) 436-6080
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2141 | OH | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124236302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 W WILSON BRIDGE RD",
"address_2": "SUITE 350",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430852237",
"telephone_number": "614-436-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 W WILSON BRIDGE RD",
"address_2": "SUITE 350",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430852237",
"telephone_number": "614-436-6080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "RICHARD",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "OH",
"license": "2141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worthington, OH
Sources for this page
- 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.