Individual provider Active NPI

Bonnie Porter Russell, R.PH.

  • Pharmacist
  • Elizabethtown, KY
National Provider Identifier
1780674408
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
006991 Issued in KY
Practice address
910 N Dixie Ave
Elizabethtown, KY 42701-2519
Phone
(270) 769-3717
Fax
(270) 769-2887
NPI assigned
Oct 25, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 006991 KY Primary

Addresses

Primary practice location

910 N Dixie Ave
Elizabethtown, KY 42701-2519

Mailing address

40 Holly Hill Dr
Elizabethtown, KY 42701-8917
Phone (270) 737-4245

Other identifiers 1

IdentifierTypeStateIssuer
006992OtherKYPHARMACIST LICENSCE NUMBE

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
006991KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780674408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HOLLY HILL DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018917",
            "telephone_number": "270-737-4245",
            "fax_number": "270-769-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 N DIXIE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012519",
            "telephone_number": "270-769-3717",
            "fax_number": "270-769-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BONNIE",
        "middle_name": "PORTER",
        "name_prefix": "Mrs.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "006991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSCE NUMBE",
            "identifier": "006992",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.