Individual provider Active NPI

William Russo, DC

  • Chiropractor
  • Wakefield, RI
National Provider Identifier
1194536649
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DCP00732 Issued in RI
Practice address
41 Mautucket Rd
Wakefield, RI 02879-5018
Phone
(401) 284-6410
NPI assigned
Jan 15, 2025
Last updated
Dec 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DCP00732 RI Primary

Addresses

Primary practice location

41 Mautucket Rd
Wakefield, RI 02879-5018

Mailing address

41 Mautucket Rd
Wakefield, RI 02879-5018
Phone (401) 284-6410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250130003891 SC Practitioner - Chiropractic 5890224141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Chiropractic AssociatesGroup PAC ID 3678812153, 2 clinicians

Practice addresses (Care Compare)

903 Saint Andrews Blvd
Suite B
Charleston, SC 29407-7194
Phone (843) 225-4357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5150SCMDSocial Worker
DCP00732RIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Chiropractic Associates Chiropractor CurrentSince Jan 15, 2025 Accepting new patients

Locations

903 Saint Andrews Blvd
Ste B
Charleston, SC 29407
Phone (843) 225-4357

Organizations & group practices 1

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": "1736899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1194536649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MAUTUCKET RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028795018",
            "telephone_number": "401-284-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MAUTUCKET RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028795018",
            "telephone_number": "401-284-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "RI",
            "license": "DCP00732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.