Kyle A Russell, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

17542 Issued in OK

Practice address

220 S St, Hwy Ok- 97
Sand Springs, OK 74063

Phone

(918) 245-9523

NPI assigned

Nov 3, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Wal-Mart Stores East LP

  • Community/Retail Pharmacy
  • Sand Springs, OK
  • NPI 1831117597
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1760083166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 N 7TH ST APT 4121",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122874",
            "telephone_number": "918-407-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S ST, HWY OK- 97",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "74063",
            "telephone_number": "918-245-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KYLE",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "17542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Robbins
• Kym Roberts-Hardesty, C. AC.
• Joseph Edward Rodriguez
• Dakota Bell Russell, APRN
• Jeffrey David Russell, D.C.
• Dean Ruth
• Taylor Salingue, OTA
• Sand Springs Dentistry and Braces
• Sand Springs Medical Associates
• Sand Springs Primary Eyecare

• Pharmacist in Sand Springs, OK
• Providers in Sand Springs, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.