Active NPI
Russell Albert Hartwick Jr., DO
- Family Medicine Physician
- Jackson, OH
National Provider Identifier
1235116583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34005013
- Practice address
- 500 Burlington Rd
Ste 260
Jackson, OH 45640-9360 - Phone
- (740) 577-9181
- Fax
- (740) 577-9214
- NPI assigned
- Dec 28, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34005013 | OH | Primary |
Addresses
Primary practice location
500 Burlington Rd
Ste 260
Jackson, OH 45640-9360
Mailing address
PO Box 190
Jackson, OH 45640-0190
Phone (740) 577-9181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0789893 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Family Practice LLC | Family Medicine | Current | Accepting new patients |
Locations
500 Burlington Rd
Ste 260
Jackson, OH 45640
Phone (740) 577-9181
Interoperability endpoints
- russell.hartwick@jfpl-oh.direct.office.nextgen.com
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Jackson, OH
- NPI 1467819920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458777600000",
"number": "1235116583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 190",
"city": "JACKSON",
"state": "OH",
"postal_code": "456400190",
"telephone_number": "740-577-9181",
"fax_number": "740-577-9214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 BURLINGTON RD",
"address_2": "STE 260",
"city": "JACKSON",
"state": "OH",
"postal_code": "456409360",
"telephone_number": "740-577-9181",
"fax_number": "740-577-9214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTWICK",
"first_name": "RUSSELL",
"middle_name": "ALBERT",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-28",
"last_updated": "2016-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34005013",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0789893",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.