David L. Russell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1264-3 Issued in KS

Practice address

1218 North 79TH Street
Kansas City, KS 66112-3308

Phone

(913) 788-3234

NPI assigned

Aug 2, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320451200000",
    "number": "1578564522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 NORTH 79TH STREET",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661123308",
            "telephone_number": "913-788-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 NORTH 79TH STREET",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661123308",
            "telephone_number": "913-788-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DAVID",
        "middle_name": "L.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2011-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1264-2",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1264-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100218380A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Runyan, PHARM.D.
• Adriana Rush, MD
• Timothy Ray Rush II, DPT
• Elizabeth Rusinko, PH.D., BCBA
• Christy M Russell, ARNP-C
• Elizabeth Russell, LCPC, LPC, NCC
• Jaye Russell
• Riley L Russell, FNP-C
• Kathryn Lenore Rutkowski, APRN
• Erika Lynn Ruud, M.D.

• Optometrist in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.