Individual provider Active NPI

Russell William Williams III, DC

  • Chiropractor
  • Utica, NY
National Provider Identifier
1629148044
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
011274 Issued in NY
Practice address
130 Lomond CT
Utica, NY 13502-5951
Phone
(315) 732-3400
Fax
(315) 732-4250
NPI assigned
Nov 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 011274 NY Primary

Addresses

Primary practice location

130 Lomond CT
Utica, NY 13502-5951

Mailing address

6158 Morris Rd
Marcy, NY 13403-3311
Phone (315) 525-6846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071003000043 NY Practitioner - Chiropractic 9830284090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

331 Oriskany Blvd
Whitesboro, NY 13492-1424
Phone (315) 525-6846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Russell W Williams III, DC, PLLC Chiropractor CurrentSince Dec 1, 2019 Accepting new patients
Donald a. Flihan, D.D.S., M.D., P.C. Past Accepting new patients

Locations

331 Oriskany Blvd
Whitesboro, NY 13492
Phone (315) 525-6846

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629148044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6158 MORRIS RD",
            "city": "MARCY",
            "state": "NY",
            "postal_code": "134033311",
            "telephone_number": "315-525-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LOMOND CT",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025951",
            "telephone_number": "315-732-3400",
            "fax_number": "315-732-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RUSSELL",
        "middle_name": "WILLIAM",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "011274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.