Individual provider Active NPI

Robert Lewis Russel, PHARMD

  • Pharmacist
  • Kennewick, WA
National Provider Identifier
1184914624
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
00056215 Issued in WA
Practice address
1321 N Columbia Center Blvd
Ste 845
Kennewick, WA 99336-2455
Phone
(509) 783-3413
Fax
(509) 735-2803
NPI assigned
Apr 18, 2011
Last updated
Apr 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 00056215 WA Primary

Addresses

Primary practice location

1321 N Columbia Center Blvd
Ste 845
Kennewick, WA 99336-2455

Mailing address

1321 N Columbia Center Blvd
Ste 845
Kennewick, WA 99336-2455
Phone (509) 783-3413

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
00056215WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1184914624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 N COLUMBIA CENTER BLVD",
            "address_2": "STE 845",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362455",
            "telephone_number": "509-783-3413",
            "fax_number": "509-735-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N COLUMBIA CENTER BLVD",
            "address_2": "STE 845",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362455",
            "telephone_number": "509-783-3413",
            "fax_number": "509-735-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSEL",
        "first_name": "ROBERT",
        "middle_name": "LEWIS",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "00056215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; 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.