Active NPI
Donald Ray Russell, RPH
- Pharmacist
- Camby, IN
National Provider Identifier
1225631948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26012545A
- Practice address
- 8191 Upland Bend
Camby, IN 46113 - Phone
- (317) 856-9521
- NPI assigned
- Nov 17, 2020
- Last updated
- Nov 17, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26012545A | IN | Primary |
Addresses
Primary practice location
8191 Upland Bend
Camby, IN 46113
Mailing address
2353 Brentford Lane
Greenwood, IN 46143-0135
Phone (317) 258-7557
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26012545A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients |
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": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1225631948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2353 BRENTFORD LANE",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461430135",
"telephone_number": "317-258-7557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8191 UPLAND BEND",
"city": "CAMBY",
"state": "IN",
"postal_code": "46113",
"telephone_number": "317-856-9521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "DONALD",
"middle_name": "RAY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-17",
"last_updated": "2020-11-17",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26012545A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camby, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.