Russell C. Spotts

Primary specialty

PharmacistTaxonomy code 183500000X

License

768 Issued in IA

Legal business name

RUSSELL C. SPOTTS

Doing business as

Ida Grove Pharmacy

Practice address

506 2ND St
Ida Grove, IA 51445-1305

Phone

(712) 364-2734

Fax

(712) 364-3068

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Russell Clinton Spotts, RPH

Title

Pharmacist

Phone

(712) 364-2734

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ida Grove Pharmacy Doing business as

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508985508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 2ND ST",
            "city": "IDA GROVE",
            "state": "IA",
            "postal_code": "514451305",
            "telephone_number": "712-364-2734",
            "fax_number": "712-364-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 2ND ST",
            "city": "IDA GROVE",
            "state": "IA",
            "postal_code": "514451305",
            "telephone_number": "712-364-2734",
            "fax_number": "712-364-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL C. SPOTTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPOTTS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "CLINTON",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "712-364-2734",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0257360",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "1606360",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ida Grove Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Michelle Lynn Siebrecht, PA
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• Pharmacist in Ida Grove, IA
• Providers in Ida Grove, IA by specialty
• Pharmacist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.