Active NPI
Russell James Frisillo, D.C.
- Chiropractor
- Broken Arrow, OK
National Provider Identifier
1700965951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- OK3296
- Practice address
- 710 N Elm Ave
Suite a
Broken Arrow, OK 74012-2574 - Phone
- (918) 251-9975
- Fax
- (918) 251-9259
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | OK3296 | OK | Primary |
Addresses
Primary practice location
710 N Elm Ave
Suite a
Broken Arrow, OK 74012-2574
Mailing address
710 N Elm Ave
Suite a
Broken Arrow, OK 74012-2574
Phone (918) 251-9975
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OK3296 | OK | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576627200000",
"number": "1700965951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 N ELM AVE",
"address_2": "SUITE A",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740122574",
"telephone_number": "918-251-9975",
"fax_number": "918-251-9259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 N ELM AVE",
"address_2": "SUITE A",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740122574",
"telephone_number": "918-251-9975",
"fax_number": "918-251-9259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRISILLO",
"first_name": "RUSSELL",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2019-12-18",
"certification_date": "2019-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "OK3296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.