Active NPI
Russell B Hennessey
- Anesthesiology Physician
- Vivian, LA
National Provider Identifier
1497793236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 022466
- Practice address
- 1000 S Spruce St
Vivian, LA 71082-3232 - Phone
- (318) 375-3239
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 022466 | LA | Primary |
Addresses
Primary practice location
1000 S Spruce St
Vivian, LA 71082-3232
Mailing address
3025 Old Mooringsport Rd
Shreveport, LA 71107-4022
Phone (318) 797-1743
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1944569 | Medicaid | LA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 022466 | LA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1497793236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3025 OLD MOORINGSPORT RD",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711074022",
"telephone_number": "318-797-1743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S SPRUCE ST",
"city": "VIVIAN",
"state": "LA",
"postal_code": "710823232",
"telephone_number": "318-375-3239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNESSEY",
"first_name": "RUSSELL",
"middle_name": "B",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "LA",
"license": "022466",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1944569",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vivian, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.