Russell Forest Stanley, D.O.

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

License

S0996 Issued in TX

Practice address

1100 E Lake St Ste 260
Tyler, TX 75701-3359

Phone

(903) 590-5700

Fax

(903) 590-5735

NPI assigned

May 4, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL, TX2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

University of North Texas HSC, College of Osteopathic Med, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
• Ut Health East Texas Pittsburg Hospital Hospital, Pittsburg, TX, CCN 451367
• Ut Health East Texas Quitman Hospital Hospital, Quitman, TX, CCN 451380
• Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rstanley1136596@ahs.direct-ci.com
• Direct secure messaging: russell.stanley.1@17217.direct.athenahealth.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Longview Wellness Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1942269493

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Obhg Texas Holdings, P.a.

  • Obstetrics & Gynecology Physician
  • Austin, TX
  • NPI 1083917769
  Medicare reassignment NPD
• Med Help 280 LLC

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1174681654
  Medicare reassignment NPD
• Obhg Alabama, P.C.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1881976520

  AL

  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD
• Longview Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1255137659

  Obstetrics & Gynecology

  NPD
• Longview Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1932598752

  Obstetrics & Gynecology

  NPD
• Longview Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1447910542

  Obstetrics & Gynecology

  NPD (past)

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Pittsburg Hospital LLC

  • Critical Access Hospital
  • Pittsburg, TX
  • NPI 1184132524
  Care Compare affiliation
• Quitman Hospital LLC

  • Critical Access Hospital
  • Quitman, TX
  • NPI 1477061885
  Care Compare affiliation
• Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Tyler, TX
  • NPI 1174021695

  Inpatient rehabilitation facility

  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295
  Care Compare affiliation

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1356797740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-606-6400",
            "fax_number": "903-606-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E LAKE ST STE 260",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013359",
            "telephone_number": "903-590-5700",
            "fax_number": "903-590-5735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E Dawson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012036",
            "country_code": "US",
            "telephone_number": "903-606-5121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "RUSSELL",
        "middle_name": "FOREST",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "S0996",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "DO.2123",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AL",
            "license": "2123",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "TX",
            "license": "S0996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrstanley74@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1100 E Lake St Ste 260",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757013359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janet Stanford, PHYSICAL THERAPIST
• Tabatha Stanford
• Katherine Stanglin, LCSW
• Lauren Stanley, FNP-BC
• Paula Stanley
• Dennis Edward Stansbury, D.D.S.
• Amanda S Stansell
• Joseph Clinton Staples, OT
• Louise Ann Star
• Tonya Stark

• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.