Daniel Russell, CRNA

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

R639869 Issued in MS

Practice address

4500 13TH St
Gulfport, MS 39501-2515

Phone

(228) 818-0563

Fax

(228) 818-0519

NPI assigned

Nov 7, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Etas, PLLC

  • Anesthesiology Physician
  • Gulfport, MS
  • NPI 1679259360
  NPD
• Gulfport Anesthesia Services, P.a.

  • Specialist
  • Gulfport, MS
  • NPI 1821033796
  NPD (past)
• Gulfport Outpatient Anesthesia, P.a.

  • Anesthesiology Physician
  • Gulfport, MS
  • NPI 1245402148
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1689743031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-818-0563",
            "fax_number": "228-818-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-818-0563",
            "fax_number": "228-818-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DANIEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "R639869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00120416",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James A Rungo, LMT
• Cristina Rupp, NP
• James Allen Rusch, M.D.
• Carla Ann Rushing, AGACNP
• Kari Rusnak, M.A.,LPC
• Ladonna Russum, RBT
• RX Solutions, Inc
• James Ryan, N.P.
• Rachel Ryan, PCCSS
• Alena Ryder

• Anesthesiology Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Anesthesiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.