Individual provider Active NPI

Howard W Russell, M.D.

  • Gynecology Physician
  • Houma, LA
National Provider Identifier
1356452361
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD12455R Issued in LA
Practice address
8120 Main St
Ste. 302
Houma, LA 70360-3403
Phone
(985) 223-0682
Fax
(985) 223-0686
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X MD12455R LA Primary

Addresses

Primary practice location

8120 Main St
Ste. 302
Houma, LA 70360-3403

Mailing address

8120 Main St
Ste. 302
Houma, LA 70360-3403
Phone (985) 223-0682

Other identifiers 2

IdentifierTypeStateIssuer
5A764OtherLAMEDICARE PTAN
1541753MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927000886 LA Practitioner - Obstetrics/Gynecology 2961528096

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD12455RLAMDGynecology Physician

Interoperability endpoints

  • Direct secure messaging: hrussell407895@direct.ochsner.org

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1356452361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 MAIN ST",
            "address_2": "STE. 302",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703603403",
            "telephone_number": "985-223-0682",
            "fax_number": "985-223-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 MAIN ST",
            "address_2": "STE. 302",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703603403",
            "telephone_number": "985-223-0682",
            "fax_number": "985-223-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "HOWARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "LA",
            "license": "MD12455R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5A764",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1541753",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.