William Douglas Russell, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

005402 Issued in MO

Practice address

2820 Missouri Ave
Saint Louis, MO 63118-1641

Phone

(314) 773-1255

Fax

(314) 821-9889

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619077740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 MISSOURI AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181641",
            "telephone_number": "314-773-1255",
            "fax_number": "314-821-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 MISSOURI AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181641",
            "telephone_number": "314-773-1255",
            "fax_number": "314-821-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "WILLIAM",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MO",
            "license": "005402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura M Russell
• Margaret Russell, MED.,OTR/L
• Sharman Maurissa Russell, MD
• Tonya D Russell, MD
• Tristyn Russell
• Erika Lynn Russina, M.A., L.P.C.
• David Aaron Russler-Germain, MD PHD
• Emilie Veronica Russler-Germain, MD PHD
• Bryce Lauren Russo, PNP
• Shelley Russo

• Sports Physician Chiropractor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Sports Physician Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.