Hubert William Russell Jr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

HR004208 Issued in MI

Practice address

15195 Allen Rd
Southgate, MI 48195-2921

Phone

(734) 284-9800

Fax

(734) 284-9088

NPI assigned

Jun 13, 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 4

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Russell Chiropractic Health PCGroup PAC ID 8921189242, 2 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Russell Chiropractic Health P.C.

  • Chiropractor
  • Southgate, MI
  • NPI 1932276946
  Medicare reassignment Care Compare group NPD Authorized official
• Odette Chiropractic Family Health Center PLC

  • Chiropractor
  • Brownstown TWP, MI
  • NPI 1528153764
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1720021231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15195 ALLEN RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952921",
            "telephone_number": "734-284-9800",
            "fax_number": "734-284-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15195 ALLEN RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952921",
            "telephone_number": "734-284-9800",
            "fax_number": "734-284-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "HUBERT",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "HR004208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD BCBS #",
            "identifier": "OQ25014",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2906559",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW GRP # AS OF 7-18-06",
            "identifier": "95OH227870",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR RUSSELL'S INDIVDUAL #",
            "identifier": "95OH227880",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandie Ruffin
• Steve A Ruffolo
• Toni Rushlow
• Russell Chiropractic Health P.C.
• Christopher Gavin Russell, D.C.
• Milianya Marie Nicole Russell
• Vanessa Russell, BSW
• Courtney Ruvolo, DPT
• RX Optical Laboratories, Inc.
• Rhiannon Rynicki-Wilder

• Chiropractor in Southgate, MI
• Providers in Southgate, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.