Active NPI
Steven Douglas Russ, RPH
- Pharmacist
- Nevada, MO
National Provider Identifier
1861082026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 110768
- Practice address
- 900 S Adams St
Nevada, MO 64772-3210 - Phone
- (417) 667-6044
- NPI assigned
- Jan 21, 2021
- Last updated
- Jan 21, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 110768 | KS | Primary |
Addresses
Primary practice location
900 S Adams St
Nevada, MO 64772-3210
Mailing address
900 S Adams St
Nevada, MO 64772-3210
Phone (417) 667-6044
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110768 | KS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1861082026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 S ADAMS ST",
"city": "NEVADA",
"state": "MO",
"postal_code": "647723210",
"telephone_number": "417-667-6044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 S ADAMS ST",
"city": "NEVADA",
"state": "MO",
"postal_code": "647723210",
"telephone_number": "417-667-6044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSS",
"first_name": "STEVEN",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-21",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "110768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nevada, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.