Kelli Russell

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

2002011659 Issued in MO

Practice address

2238 W Kingsley St
Springfield, MO 65807-5456

Phone

(417) 831-0150

NPI assigned

Apr 21, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelli McMinn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1245175892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E TAMPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061131",
            "telephone_number": "417-831-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2238 W KINGSLEY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075456",
            "telephone_number": "417-831-0150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 E Tampa St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658061131",
            "country_code": "US",
            "telephone_number": "417-831-0150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MO",
            "license": "2002011659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "MCMINN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Rupp, R.PH.
• Monica Rush
• Wesley Benjamin Rushing, OD
• Bailee D Russell, OT
• Indy Russell
• Melody Ann Russell, ACAGNP-BC
• Shannon Russell
• Wilburn Russell Jr., LPC
• Mandy L Rust, NP
• Sherri L Rust, MA, LPC

• Dental Hygienist in Springfield, MO
• Providers in Springfield, MO by specialty
• Dental Hygienist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.