Individual provider Active NPI

Joshua Allan Russell, OD

  • Optometrist
  • Leavenworth, KS
National Provider Identifier
1801637244
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2254 Issued in KS
Practice address
2301 10TH Ave
Leavenworth, KS 66048-4214
Phone
(913) 682-2929
NPI assigned
May 31, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3277 OK
Optometrist 152W00000X 2025000170 MO
Optometrist 152W00000X 2254 KS Primary

Addresses

Primary practice location

2301 10TH Ave
Leavenworth, KS 66048-4214

Mailing address

2301 10TH Ave
Leavenworth, KS 66048-4214
Phone (913) 682-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250920000646 KS Practitioner - Optometry 8325542400 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norris and Kelly PAGroup PAC ID 5890747711, 7 clinicians

Practice addresses (Care Compare)

2301 10TH Ave
Leavenworth, KS 66048-4214
Phone (913) 682-2929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025000170MOMDOptometrist
2254KSMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wyandotte Family Eyecare Center, LLC Optometrist CurrentSince Jul 11, 2025 Accepting new patients
Family Eyecare Center Lansing LLC Optometrist CurrentSince Jul 11, 2025 Accepting new patients
Norris and Kelly, P.a. Optometrist CurrentSince Jul 11, 2025 Accepting new patients
Family Eyecare Center of Bonner Springs LLC Optometrist CurrentSince Jul 11, 2025 Accepting new patients
Family Eyecare Center of Desoto Kansas LLC Optometrist CurrentSince Sep 29, 2025 Accepting new patients

Locations

13047 Kansas Ave
Bonner Springs, KS 66012
Phone (913) 441-4050

8781 Lexington Ave
Ste 11
De Soto, KS 66018
Phone (913) 290-5085

21 N 12th St
Ste 102
Kansas City, KS 66102
Phone (913) 342-4405

2301 10th Ave
Leavenworth, KS 66048
Phone (913) 680-1365

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1801637244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 10TH AVE",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660484214",
            "telephone_number": "913-682-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 10TH AVE",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660484214",
            "telephone_number": "913-682-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOSHUA",
        "middle_name": "ALLAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-31",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3277",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2025000170",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, KS

Sources for this page

Verify at the official NPI Registry.