John Russell Luellen, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD065589L Issued in PA

Practice address

1000 Dutch Ridge Rd
Beaver, PA 15009-9727

Phone

(724) 773-3418

Fax

(724) 773-4648

NPI assigned

Jun 30, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bon Secours Medical Group Hampton Roads Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Franklin, VA
  • NPI 1205451028
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1609873181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9011 PEREGRINE DR",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150448061",
            "telephone_number": "412-913-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DUTCH RIDGE RD",
            "city": "BEAVER",
            "state": "PA",
            "postal_code": "150099727",
            "telephone_number": "724-773-3418",
            "fax_number": "724-773-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUELLEN",
        "first_name": "JOHN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD065589L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017116600001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017116600011",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2229190",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Lynn Logan, M.S. CCC-SLP
• Janey Lynn Long, DPT
• Georgia Lee Lough, MA CCC/SLP
• Dylan Thomas Loverich, L.AC
• Carol B Luce, PHD
• Sarah E Lundquist, PA-C
• Lung & Wellness Centers of Western Pennsylvania Inc
• Michael L Lustbader, M.D.
• Courtney Lynch, PHARM.D.
• Penelope Field Lyon, MSW

• Emergency Medicine Physician in Beaver, PA
• Providers in Beaver, PA by specialty
• Emergency Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.