Active NPI
Russel Marion Newton II, PH.D
- Psychologist
- Columbia, MO
National Provider Identifier
1891905428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 00828
- Practice address
- 1715W.Worley St.
Ste.a
Columbia, MO 65203 - Phone
- (573) 446-1614
- Fax
- (573) 446-8532
- NPI assigned
- May 23, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 00828 | MO | Primary |
Addresses
Primary practice location
1715W.Worley St.
Ste.a
Columbia, MO 65203
Mailing address
1715 W Worley St
Ste.a
Columbia, MO 65203-1015
Phone (573) 446-1614
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00828 | MO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891905428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 W WORLEY ST",
"address_2": "STE.A",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652031015",
"telephone_number": "573-446-1614",
"fax_number": "573-446-8532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715W.WORLEY ST.",
"address_2": "STE.A",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65203",
"telephone_number": "573-446-1614",
"fax_number": "573-446-8532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWTON",
"first_name": "RUSSEL",
"middle_name": "MARION",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "00828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.