Russell E Tackett, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

R6B18 Issued in MO

Practice address

6400 Prospect Ave
Suite440
Kansas City, MO 64132-1100

Phone

(816) 361-0277

Fax

(916) 361-4733

NPI assigned

Oct 25, 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

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1821172768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 PROSPECT AVE",
            "address_2": "SUITE440",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641321100",
            "telephone_number": "816-361-0277",
            "fax_number": "916-361-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 PROSPECT AVE",
            "address_2": "SUITE440",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641321100",
            "telephone_number": "816-361-0277",
            "fax_number": "916-361-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "RUSSELL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "R6B18",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monir Tabbosha, MD
• Allison Elizabeth Taber, M.D.
• Elvira Constantino Tabije, CRNFA
• Eugenio Miguel Taboada-Arana, M.D.
• Marie Ann B Taboada, FNP-C
• Shourya Tadisina, MD
• Jean Tadokoro, MSW
• Kira Tafoya
• Jessica J Taggart, ARNP
• Sascha Darius Taghizadeh, MD

• Urology Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Urology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.