Russell King Heltsley III, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1216 DT Issued in KY

Practice address

2425 Scottsville Rd
Suite #114
Bowling Green, KY 42104-4457

Phone

(270) 846-2500

Fax

(270) 846-0608

NPI assigned

Oct 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Health Corporation, Inc.Group PAC ID 5496667628, 268 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Commonwealth Health Corporation, Inc

  dba Med Center Health Neurology

  • Neurology Physician
  • Bowling Green, KY
  • NPI 1881109304
  Medicare reassignment Care Compare group NPD
• Commonwealth Health Corporation, Inc

  dba Med Center Health Surgical Specialists

  • Surgery Physician
  • Albany, KY
  • NPI 1922539188
  NPD
• Commonwealth Health Corporation, Inc.

  dba Med Center Health Plastic & Reconstructive Surgery

  • Plastic and Reconstructive Surgery Physician
  • Bowling Green, KY
  • NPI 1104470699
  NPD
• Commonwealth Health Corporation

  dba SMP Physicians

  • Family Medicine Physician
  • Scottsville, KY
  • NPI 1508899089
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1184709636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 SCOTTSVILLE RD",
            "address_2": "SUITE #114",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044457",
            "telephone_number": "270-846-2500",
            "fax_number": "270-846-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 SCOTTSVILLE RD",
            "address_2": "SUITE #114",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421044457",
            "telephone_number": "270-846-2500",
            "fax_number": "270-846-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELTSLEY",
        "first_name": "RUSSELL",
        "middle_name": "KING",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1216 DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77012169",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mychaela Helton, LPCA
• Catherine G Heltsley, MD
• Emma Ruth Heltsley
• James Ralph Heltsley Jr., D.O.
• Nathaniel Heltsley, LCSW
• Rodney McKinley Henderson, RODNEY HENDERSON
• Jonathan David Hendrie, MD
• Kara Nicole Hendrix, DMD
• Sydney Hendrix
• Wayne Hendrix, M.D.

• Optometrist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.