Organization Active NPI

John J. Russell, MD, PC

  • Pediatrics Physician
  • Cape Girardeau, MO
National Provider Identifier
1811020225
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
100521 Issued in MO
Legal business name
JOHN J. RUSSELL, MD, PC
Practice address
1435 N Mount Auburn Rd
Suite 200
Cape Girardeau, MO 63701-2171
Phone
(573) 335-4209
Fax
(573) 335-5524
NPI assigned
Mar 14, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. John J Russell, M.D.
Title
President
Phone
(573) 335-4209

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 100521 MO
Pediatrics Physician 208000000X 100521 MO Primary

Addresses

Primary practice location

1435 N Mount Auburn Rd
Suite 200
Cape Girardeau, MO 63701-2171

Mailing address

1435 N Mount Auburn Rd
Suite 200
Cape Girardeau, MO 63701-2171
Phone (573) 335-4209

National Provider Directory

National Provider Directory

Locations

1610 N Kingshighway St
Ste 304
Cape Girardeau, MO 63701
Phone (573) 335-2191

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1811020225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 N MOUNT AUBURN RD",
            "address_2": "SUITE 200",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012171",
            "telephone_number": "573-335-4209",
            "fax_number": "573-335-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 N MOUNT AUBURN RD",
            "address_2": "SUITE 200",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012171",
            "telephone_number": "573-335-4209",
            "fax_number": "573-335-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J. RUSSELL, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-335-4209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "100521",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "100521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.