R. Denis Russell, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E1393 Issued in CA

Practice address

11100 Warner Ave
Suite 306
Fountain Valley, CA 92708-7506

Phone

(714) 979-0313

Fax

(714) 979-0340

NPI assigned

Jul 7, 2005

Reactivated

Mar 27, 2006

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)

Enrolled

State licenses

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1790783439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 306",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-979-0313",
            "fax_number": "714-979-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 306",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-979-0313",
            "fax_number": "714-979-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "R.",
        "middle_name": "DENIS",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-02-15",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E1393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Rury
• Russell P Rapoza M D a Professional Corporation
• Danielle Marie Russell
• Kendal Corrine Russell
• Kim Russell, PHARMD
• Michael Anthony Russo, MD
• Ryan W Jamison DO Inc
• Brenda Jean Ryan, NP
• Lauren Elizabeth Ryder
• Sachin R Sabhlok

• Foot & Ankle Surgery Podiatrist in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.