Robert C Russell M D S C

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036061657 Issued in IL

Legal business name

ROBERT C RUSSELL M D S C

Practice address

320 E Carpenter St
Springfield, IL 62702-5185

Phone

(217) 523-0808

Fax

(217) 753-5324

NPI assigned

Oct 14, 2006

Organization subpart

No

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

Authorized official

Name

Robert C Russell, MD

Title

Ownerpresiden

Phone

(217) 523-0808

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ROBERT C RUSSELL M D S C Doing business as

Locations

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363824000000",
    "number": "1396835641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025185",
            "telephone_number": "217-523-0808",
            "fax_number": "217-753-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025185",
            "telephone_number": "217-523-0808",
            "fax_number": "217-753-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C RUSSELL M D S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-14",
        "last_updated": "2013-03-21",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNERPRESIDEN",
        "authorized_official_telephone_number": "217-523-0808",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IL",
            "license": "036061657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061657",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROBERT C RUSSELL M D S C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brent Riva, CRNA
• Kelly Rivera, LCSW
• Nicolas Paul Rivera, CRNA
• Rex Rizaldo, APRN
• Kevin T Robbins, M.D.
• Emily C Roberts, MSW
• Hannah Marie Roberts, MD
• Jennifer Roberts, LPN
• Nellie Caroline Roberts, MD
• Samantha Roberts, RPH

• Surgery Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.