Russell Chiropractic LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3307 Issued in OH

Legal business name

RUSSELL CHIROPRACTIC LTD

Practice address

18624 Detroit Ave
Lakewood, OH 44107-3202

Phone

(216) 221-1788

Fax

(216) 221-2820

NPI assigned

Mar 5, 2008

Last updated

Mar 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael A Russell, DCNPI 1962502880

Title

Owner

Phone

(216) 221-1788

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael A Russell, DC

  • Chiropractor
  • Lakewood, OH
  • NPI 1962502880
  Medicare reassignment NPD Authorized official
• Tessa Madlyn Larue, DC

  • Chiropractor
  • Lakewood, OH
  • NPI 1902360357
  NPD (past)

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1467622480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18624 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073202",
            "telephone_number": "216-221-1788",
            "fax_number": "216-221-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18624 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073202",
            "telephone_number": "216-221-1788",
            "fax_number": "216-221-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL CHIROPRACTIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-221-1788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2321553",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "299807273002",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "232365",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Ross, O.D.
• Brye Roth, LPCC-S
• Lawrence M Roth, LSW, CDCA
• Elizabeth Ruiz
• Joyce M Rusnak, SLP
• Anna Russell
• Michael A Russell, DC
• Whit Ryan, PSYD
• Isabella Rybak
• Barbara A. Sabol, S.T.

• Chiropractor in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.