Russel Jerome Legreid II, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

01074428A Issued in IN

Practice address

1026 S Main St
Bluffton, IN 46714-3614

Phone

(260) 353-2023

Fax

(260) 824-7244

NPI assigned

Jun 8, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• R.J. Legreid II, MD

  • Specialist
  • Pulaski, TN
  • NPI 1376712927
  NPD (past) Authorized official
• Markle Medical Center, Inc

  • Family Medicine Physician
  • Bluffton, IN
  • NPI 1740252980
  NPD (past)
• Atlanta ENT Sinus & Allergy Associates PC

  • Specialist
  • Atlanta, GA
  • NPI 1285619544
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407897978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3513",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 S MAIN ST",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467143614",
            "telephone_number": "260-353-2023",
            "fax_number": "260-824-7244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W Horton St",
            "address_purpose": "LOCATION",
            "city": "Bluffton",
            "state": "IN",
            "postal_code": "467143607",
            "country_code": "US",
            "telephone_number": "260-824-0800",
            "fax_number": "260-824-7243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGREID",
        "first_name": "RUSSEL",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "39319",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "01074428A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201250850",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407897978",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Marie Kukelhan, DDS
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• Amy Lai, MD
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• Stephanie Lantz
• Roger D. Lemmen, M.D.
• Richard J Leo, M.D.
• Charles S Lindzy, MD
• Loving Shepherd International Services & Foundation, Inc.
• Lutheran HBP Services, LLC

• Specialist in Bluffton, IN
• Providers in Bluffton, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.