Active NPI
George Russell, D.C.
- Chiropractor
- New York, NY
National Provider Identifier
1205038932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X009793-1
- Practice address
- 101 5TH Ave
Suite 10C
New York, NY 10003-1023 - Phone
- (646) 654-9529
- Fax
- (212) 488-2121
- NPI assigned
- Jun 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X009793-1 | NY | Primary |
Addresses
Primary practice location
101 5TH Ave
Suite 10C
New York, NY 10003-1023
Mailing address
101 5TH Ave
Suite 10C
New York, NY 10003-1023
Phone (646) 654-9529
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 562587529 0000 | Other | PA | CIGNA HEALTHCARE INC. |
| P3695979 | Other | CT | OHI INC. (OXFORD) |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X009793-1 | NY | MD | Chiropractor |
| 009793 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205038932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 5TH AVE",
"address_2": "SUITE 10C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100031023",
"telephone_number": "646-654-9529",
"fax_number": "212-488-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 5TH AVE",
"address_2": "SUITE 10C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100031023",
"telephone_number": "646-654-9529",
"fax_number": "212-488-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "GEORGE",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X009793-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE INC.",
"identifier": "562587529 0000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHI INC. (OXFORD)",
"identifier": "P3695979",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.