John Michael Russell, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

ME57356 Issued in FL

Practice address

315 Palm Coast Pkwy NE
Suite 3
Palm Coast, FL 32137-3888

Phone

(386) 447-4440

Fax

(386) 447-4446

NPI assigned

Aug 30, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1629061189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 PALM COAST PKWY NE",
            "address_2": "SUITE 3",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373888",
            "telephone_number": "386-447-4440",
            "fax_number": "386-447-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 PALM COAST PKWY NE",
            "address_2": "SUITE 3",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373888",
            "telephone_number": "386-447-4440",
            "fax_number": "386-447-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME57356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252330200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelica Ruiz
• Rural Health Care Incorporated (Aza Health)
• Rural Health Care, Inc (Aza Health #09)
• Rural Therapy Services of Florida Inc (Palm Coast Sports Medicine & Rehab Center Inc)
• Kayla A Rusin
• Elvis Scott Rutledge, RN
• Nargiz Ruzmetova
• Angela Pearl Ryan, PSYD
• S & B Kingdom Care L.L.C
• S and S United 'LLC' (American Chiropractic and Spinal Decompression Center)

• Orthopaedic Surgery Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Orthopaedic Surgery Physician in Florida

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