NPIMap

Individual provider Active NPI

Scott C Russell, MD

  • Internal Medicine Physician
  • Kansas City, MO
National Provider Identifier
1316904295
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2007024413 Issued in MO
Practice address
4321 Washington St
Suite 3000
Kansas City, MO 64111-5961
Phone
(816) 932-3100
Fax
(816) 932-6863
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2007024413 MO Primary

Addresses

Primary practice location

4321 Washington St
Suite 3000
Kansas City, MO 64111-5961

Mailing address

4321 Washington St
Suite 3000
Kansas City, MO 64111-5961
Phone (816) 932-3100

Other identifiers 1

IdentifierTypeStateIssuer
206233900MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080112000065 MO Practitioner - Internal Medicine 6507947819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4321 Washington
Kansas City, MO 64111-5928

601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700

601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc Internal Medicine CurrentSince Jan 7, 2008 Accepting new patients

Locations

4321 Washington St
Ste 3000
Kansas City, MO 64111
Phone (816) 932-3100

901 E 104th St
#400N
Kansas City, MO 64131
Phone (816) 502-8756

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: srussell5202@direct.saint-lukes.org

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1316904295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 WASHINGTON ST",
            "address_2": "SUITE 3000",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115961",
            "telephone_number": "816-932-3100",
            "fax_number": "816-932-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 WASHINGTON ST",
            "address_2": "SUITE 3000",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115961",
            "telephone_number": "816-932-3100",
            "fax_number": "816-932-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SCOTT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2007024413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206233900",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.