Elizabeth Joyce Russell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

37344 Issued in WI

Practice address

820 Arbutus Ave
Oconto, WI 54153-2004

Phone

(920) 835-1100

Fax

(920) 835-1099

NPI assigned

Aug 8, 2006

Last updated

Sep 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellin Health Oconto Hospital Hospital, Oconto, WI, CCN 521356

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: erussell891974@direct.emplifyhealth.org
• FHIR API: https://eprescribe.sanfordhealth.org/FHIR/api/FHIR/R4/

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.

• Oconto Hospital & Medical Center Inc

  dba Emplify Health Oconto Hospital

  • Critical Access Hospital
  • Oconto, WI
  • NPI 1356373302
  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health Algoma

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473

  Family Medicine

  Medicare reassignment NPD
• Green Bay Emergency Medicine Services S.C.

  • Emergency Medicine Physician
  • Green Bay, WI
  • NPI 1366424111
  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Oconto Hospital & Medical Center Inc

  dba Bellin Health Suring

  • Rural Health Clinic/Center
  • Suring, WI
  • NPI 1104418037

  Family Medicine

  NPD
• Community Memorial Hospital

  dba Community Memorial Hospital Social Services

  • Clinical Social Worker
  • Oconto Falls, WI
  • NPI 1629302831
  NPD (past)
• Community Memorial Hospital, Incorporated

  dba d/b/a Breast Surgery Experts of Northeast Wisconsin LLC

  • Surgery Physician
  • Green Bay, WI
  • NPI 1093096224
  NPD (past)
• Community Memorial Hospital, Incorporated

  dba d/b/a Breast Surgery Experts of Northeast Wisconsin

  • Surgery Physician
  • Oconto Falls, WI
  • NPI 1386925915
  NPD (past)
• Community Memorial Hospital, Incorporated

  dba d/b/a Breast Surgery Experts of Northeast Wisconsin

  • Surgery Physician
  • Neenah, WI
  • NPI 1801177035
  NPD (past)
• St Clare Memorial Hospital, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Oconto Falls, WI
  • NPI 1326349135
  NPD (past)
• St Clare Memorial Hospital, Inc.

  dba St Clare Memorial Hospital Pharmacy

  • Institutional Pharmacy
  • Oconto Falls, WI
  • NPI 1073536967
  NPD (past)

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

• Oconto Hospital & Medical Center Inc

  dba Emplify Health Oconto Hospital

  • Critical Access Hospital
  • Oconto, WI
  • NPI 1356373302
  Care Compare affiliation

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1851301253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 ARBUTUS AVE",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541532004",
            "telephone_number": "920-835-1100",
            "fax_number": "920-835-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543136089",
            "country_code": "US",
            "telephone_number": "920-433-4737",
            "fax_number": "920-433-4789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ELIZABETH",
        "middle_name": "JOYCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11014110",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMH NPI",
            "identifier": "1851477913",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32194900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD OF FAMILY MEDICINE",
            "identifier": "537527",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prevea Clinic, Inc.
• Prevea Clinic, Inc.
• Michael Reimer, LCSW
• Bruce W Retzlaff, MSW
• Megan Ann Robers, PT, DPT
• David Schreiter, CSAC
• Shopko #602
• Shopko Stores Operating Co LLC (ShopKo Optical 602)
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 602)
• Joshua M Simpson, DMD

• Family Medicine Physician in Oconto, WI
• Providers in Oconto, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.