NPIMap

Organization Active NPI

Dr Russell O Schub PA

  • Gastroenterology Physician
  • Columbia, MD
National Provider Identifier
1336332998
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
DR RUSSELL O SCHUB PA
Practice address
8875 Centre Park Dr
Suite D
Columbia, MD 21045-2382
Phone
(410) 730-1000
Fax
(410) 730-8615
NPI assigned
Aug 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
Russell O. Schub, D.O.
Title
President
Phone
(410) 730-1000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0100X Primary
Adult Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

8875 Centre Park Dr
Suite D
Columbia, MD 21045-2382

Mailing address

8875 Centre Park Dr
Suite D
Columbia, MD 21045-2382
Phone (410) 730-1000

Other identifiers 3

IdentifierTypeStateIssuer
526471500MedicaidMD
8338RUOtherMDBLUE SHIELD
C428OtherDCBLUE SHIELD

National Provider Directory

National Provider Directory

Locations

2850 North Ridge Rd
Ste 211
Ellicott City, MD 21043

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1336332998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8875 CENTRE PARK DR",
            "address_2": "SUITE D",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452382",
            "telephone_number": "410-730-1000",
            "fax_number": "410-730-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8875 CENTRE PARK DR",
            "address_2": "SUITE D",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452382",
            "telephone_number": "410-730-1000",
            "fax_number": "410-730-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RUSSELL O SCHUB PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "SCHUB",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-730-1000",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "526471500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8338RU",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "C428",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.