Andrew Colin Russell, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036.134694 Issued in IL

Practice address

28 Country Club VW
Edwardsville, IL 62025-3626

Phone

(573) 424-9110

NPI assigned

Mar 22, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

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 2

Specialty

Emergency Medicine

Education

Saint Louis University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Emergency Anderson Health IncGroup PAC ID 8022401256, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Hospital Hospital, Maryville, IL, CCN 140289

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630

  W-2 Managing Employee

  CMS ownership

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.

• Midwest Emergency Anderson Health, Inc

  • Emergency Medicine Physician
  • Staunton, IL
  • NPI 1710647615
  Medicare reassignment Care Compare group NPD
• Midwest Inpatient Anderson Health, Inc

  • Emergency Medicine Physician
  • Maryville, IL
  • NPI 1821758608
  Medicare reassignment NPD

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

• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1902120819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 ILLINOIS 162",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "62062",
            "telephone_number": "618-288-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 COUNTRY CLUB VW",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253626",
            "telephone_number": "573-424-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ANDREW",
        "middle_name": "COLIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-22",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2012023819",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.134694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rozell Chiropractic Inc (Rozell Spine & Sport)
• Kenneth Ryan Rozell, D.C.
• Nicholas Morey Rozell, DC
• Delaney Nichole Ruby, RN
• Hannah Kate Ruesch
• Ashlyn Russo
• Madison Kathleen Ruzicka, HIS
• Nicole Adraneda Ryan
• Timothy Samet
• Faith Elizabeth Sanders

• Emergency Medicine Physician in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.