Individual provider Active NPI

Joseph Paul Russell, D.C.

  • Chiropractor
  • Tracy, CA
National Provider Identifier
1174701882
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC30800 Issued in CA
Practice address
438 W Beverly PL Ste 101
Tracy, CA 95376-3011
Phone
(209) 832-9221
Fax
(209) 832-9297
NPI assigned
Feb 5, 2008
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC30800 CA Primary

Addresses

Primary practice location

438 W Beverly PL Ste 101
Tracy, CA 95376-3011

Mailing address

438 W Beverly PL Ste 101
Tracy, CA 95376-3011
Phone (209) 832-9221

Other practice location 1

583 Wicklund Crossing Way
Mountain House, CA 95391-1100
Phone (209) 836-3597 ext. 2

Other practice location 2

130 N Grant Ave
Manteca, CA 95336-4601
Phone (209) 825-5610 ext. 3

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100112000070 CA Practitioner - Chiropractic 3173664232 Reassigns benefits to 1 organization
Practice locations: Tracy, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coykendall Chiropractic IncGroup PAC ID 0042674202, 3 clinicians

Practice addresses (Care Compare)

438 W Beverly PL
Suite 101
Tracy, CA 95376-3011
Phone 20983292211

438 W Beverly Place
Suite 101
Tracy, CA 95376-3011
Phone (209) 832-9221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC30800CAMDChiropractor
30800CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Coykendall Chiropractic Inc Chiropractor CurrentSince Apr 24, 2025 Accepting new patients
Garrido, Russell & Coykendall Chiropractic Corporation Chiropractor CurrentSince Mar 9, 2026 Accepting new patients
Darwin Van Wyngarden a Professional Chiropractic Corporation Chiropractor PastSince Jul 18, 2010 Accepting new patients
Garrido Russell Chiropractic Corp Chiropractor PastSince Dec 24, 2023 Accepting new patients
Applied Chiropractic Solotions Chiropractor PastSince Jan 1, 1990 Accepting new patients

Locations

130 N Grant Ave
Manteca, CA 95336
Phone (209) 825-5610

583 Wicklund Crossing Way
Mtn House, CA 95391
Phone (209) 836-3597

1444 W Main St
Ste D
Ripon, CA 95366
Phone 2095992699 ext. 4

438 W Beverly Pl
Ste 101
Tracy, CA 95376
Phone (209) 832-9221

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1174701882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 W BEVERLY PL STE 101",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763011",
            "telephone_number": "209-832-9221",
            "fax_number": "209-832-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 W BEVERLY PL STE 101",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763011",
            "telephone_number": "209-832-9221",
            "fax_number": "209-832-9297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "583 Wicklund Crossing Way",
            "address_purpose": "LOCATION",
            "city": "Mountain House",
            "state": "CA",
            "postal_code": "953911100",
            "country_code": "US",
            "telephone_number": "209-836-3597 x2",
            "fax_number": "209-834-8119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 N Grant Ave",
            "address_purpose": "LOCATION",
            "city": "Manteca",
            "state": "CA",
            "postal_code": "953364601",
            "country_code": "US",
            "telephone_number": "209-825-5610 x3",
            "fax_number": "209-982-5402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOSEPH",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-05",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

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