Individual provider Active NPI

Ladenna Russell, D.C.

  • Chiropractor
  • Cartersville, GA
National Provider Identifier
1790843472
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
GA6261 Issued in GA
Practice address
680 Douthit Ferry Rd
Suite 103
Cartersville, GA 30120-4085
Phone
(770) 387-3161
Fax
(770) 387-3162
NPI assigned
Dec 5, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X GA6261 GA Primary

Addresses

Primary practice location

680 Douthit Ferry Rd
Suite 103
Cartersville, GA 30120-4085

Mailing address

680 Douthit Ferry Rd
Suite 103
Cartersville, GA 30120-4085
Phone (770) 387-3161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070215000029 GA Practitioner - Chiropractic 3971505280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

680 Douthit Ferry Rd
Suite 103
Cartersville, GA 30120-4150
Phone (770) 387-3161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
GA6261GAMDChiropractor
006261GAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hand Clinic Inc CurrentSince Dec 21, 2015 Accepting new patients

Locations

680 Douthit Ferry Rd
Ste 103
Cartersville, GA 30120
Phone (770) 387-3161

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790843472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 DOUTHIT FERRY RD",
            "address_2": "SUITE 103",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301204085",
            "telephone_number": "770-387-3161",
            "fax_number": "770-387-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 DOUTHIT FERRY RD",
            "address_2": "SUITE 103",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301204085",
            "telephone_number": "770-387-3161",
            "fax_number": "770-387-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LADENNA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "GA6261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.