Dennis Allen Russell

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(270) 412-6016

Fax

(270) 412-9062

NPI assigned

Mar 23, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1487895330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-412-6016",
            "fax_number": "270-412-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-412-6016",
            "fax_number": "270-412-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DENNIS",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynn Ross, PA-C
• Victoria Maria Rottler, OD
• Kristy A Roux, PA-C
• Calvin Albert Rowe III, PA-C
• Sharleen Marie Rupp, AU.D.
• Timothy Glenn Russell, M.D.
• Tyler Joseph Russell
• Christina Sue Sabin, CNM
• Tracy Lynn Saboy, MSN, ANP-BC, FNP-BC
• David Moses Safarik, CRNA

• Independent Duty Corpsman in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Independent Duty Corpsman in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.