Scott Russell DO Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SCOTT RUSSELL DO INC

Doing business as

Scott Russell DO, MHA

Practice address

41120 Washington St Ste 210
Bermuda Dunes, CA 92203-9596

Phone

(760) 391-8436

NPI assigned

May 5, 2023

Last updated

May 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Scott Russell, DONPI 1073581237

Title

President

Phone

(760) 391-8436

Specialties & licenses 1

Addresses

Other names 1

• Scott Russell DO, MHA Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott Russell, DO

  • Internal Medicine Physician
  • Bermuda Dunes, CA
  • NPI 1073581237
  Medicare reassignment NPD Authorized official
• Pittawat Narktawan Emerson, NP

  • Primary Care Nurse Practitioner
  • Palm Springs, CA
  • NPI 1437492097
  Medicare reassignment NPD

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1144919911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45815 CAMINO VIS STE 210",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537231",
            "telephone_number": "760-391-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41120 WASHINGTON ST STE 210",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922039596",
            "telephone_number": "760-391-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT RUSSELL DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-391-8436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scott Russell DO, MHA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ralphs Grocery Company (Ralphs Pharmacy)
• Edward Anthony Ramirez
• Janet Lee Roberts, M.D.
• Brandon Rosi, PT, DPT, CSCS
• Scott Russell, DO
• Isai Serrano, LCSW
• Mark Shabashov, RPH
• Arif J Shaikh, M.D.
• Maridy Sherrill
• Cody Shimabukuro, DPT

• Clinic/Center in Bermuda Dunes, CA
• Providers in Bermuda Dunes, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.