Lee David Russo, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3605 Issued in SC

Practice address

1175 Folly Rd Ste E
Charleston, SC 29412-4130

Phone

(843) 225-1236

Fax

(843) 225-1237

NPI assigned

May 17, 2007

Last updated

Jan 14, 2015By the provider in NPPES

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

Enrolled in SC

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Sublime Spine, LLC

  dba Health Source of James Island

  • Chiropractor
  • Charleston, SC
  • NPI 1871894816
  Medicare reassignment NPD Authorized official
• Wiedrich LLC

  dba HealthSource of James Island

  • Chiropractor
  • Charleston, SC
  • NPI 1346414950
  NPD (past)
• Harry W. Brown, Inc.

  • Chiropractor
  • Savannah, GA
  • NPI 1225058639
  NPD (past)
• Superior Healthcare LLC

  • Physical Medicine & Rehabilitation Physician
  • Canton, GA
  • NPI 1295782514
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1841407616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 FOLLY RD STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294124130",
            "telephone_number": "843-225-1236",
            "fax_number": "843-225-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 FOLLY RD STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294124130",
            "telephone_number": "843-225-1236",
            "fax_number": "843-225-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "LEE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven L Russell, PA
• Tina Russell
• William S Russell, MD
• Andrew Peter Russo, ATC, SCAT
• Anthony J Russo, M.D.
• Sarah Brice Russo, MD, PHD
• Kassie Russom, PA-C
• Hannah Rebecca Willis Rustin, D.M.D., M.S.D.
• Brittany Ruth, PA-C
• Natasha McKerran Ruth, MD

• Chiropractor in Charleston, SC
• Providers in Charleston, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.