NPIMap

Individual provider Active NPI

Rebekah Olaoluwa Russell, DO

  • Internal Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1821593666
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T0529 Issued in TX
Practice address
921 NE 13TH St
Oklahoma City, OK 73104-5007
Phone
(405) 456-1000
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T0529 TX Primary

Addresses

Primary practice location

921 NE 13TH St
Oklahoma City, OK 73104-5007

Mailing address

921 NE 13TH St
Oklahoma City, OK 73104-5007
Phone (405) 456-1000

Other identifiers 1

IdentifierTypeStateIssuer
BP10064038OtherTXPHYSICIAN IN TRAINING

Other names 1

  • Rebekah Olaoluwa John Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240508004103 OK Practitioner - Internal Medicine 1254688559 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metro Physicians LLCGroup PAC ID 1153794813, 62 clinicians
Cypress Wound Care LLCGroup PAC ID 7315471422, 5 clinicians

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-4978

1211 N Shartel Ave
Suite 408
Oklahoma City, OK 73103-2400
Phone (405) 835-3428

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physicians LLC CurrentSince Mar 18, 2024 Accepting new patients
Family Care 323, PLLC CurrentSince Oct 1, 2024 Accepting new patients
Metro Healthcare Services LLC Internal Medicine CurrentSince Oct 1, 2024 Accepting new patients
Cypress Wound Care LLC CurrentSince Oct 1, 2024 Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
St Anthony Shawnee Hospital Inc Past Accepting new patients
SSM Health Care of Oklahoma, Inc Past Accepting new patients

Locations

1111 N Lee Ave
Ste 305
Oklahoma City, OK 73103
Phone (405) 272-4978

1000 N Lee Ave
Oklahoma City, OK 73102
Phone (405) 272-6152

1211 N Shartel Ave
Ste 408
Oklahoma City, OK 73103
Phone (405) 835-3428

Interoperability endpoints

  • Direct secure messaging: rrussell512559@direct-ehr-ssmhc.com
  • Direct secure messaging: rjohn294203@direct.sw.org

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1821593666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 NE 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045007",
            "telephone_number": "405-456-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 NE 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045007",
            "telephone_number": "405-456-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "REBEKAH",
        "middle_name": "OLAOLUWA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T0529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN IN TRAINING",
            "identifier": "BP10064038",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBEKAH",
            "last_name": "JOHN",
            "middle_name": "OLAOLUWA",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.