Individual provider Active NPI

Russell J. Dukes, M.D.

  • Pulmonary Disease Physician
  • Bloomington, IN
National Provider Identifier
1467457234
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01024466A Issued in IN
Practice address
550 S Landmark Ave
Bloomington, IN 47403-3239
Phone
(812) 331-3400
Fax
(812) 332-7265
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 01024466A IN Primary

Addresses

Primary practice location

550 S Landmark Ave
Bloomington, IN 47403-3239

Mailing address

550 Landmark Ave
P.O. Box 550
Bloomington, IN 47403-0550
Phone (812) 331-3400

Other identifiers 1

IdentifierTypeStateIssuer
100355810MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01024466AINMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare LLC Pulmonary Disease Current Accepting new patients
Indiana University Health Bloomington Inc Current Accepting new patients
Ima, Inc. Pulmonary Disease Current Accepting new patients

Locations

7987 Solution Ctr
Chicago, IL 60677

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

550 S Landmark Ave
Bloomington, IN 47403
Phone (812) 330-3688

3043 N Lintel Dr
Bloomington, IN 47404
Phone (812) 333-7622

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1467457234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 LANDMARK AVE",
            "address_2": "P.O. BOX 550",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474030550",
            "telephone_number": "812-331-3400",
            "fax_number": "812-332-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033239",
            "telephone_number": "812-331-3400",
            "fax_number": "812-332-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKES",
        "first_name": "RUSSELL",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01024466A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100355810",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.