Individual provider Active NPI

Roger Alan Russell, DC

  • Chiropractor
  • Henderson, NV
National Provider Identifier
1912987397
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
B00457 Issued in NV
Practice address
715 Mall Ring Circle
Suite 205
Henderson, NV 89014
Phone
(702) 990-2225
Fax
(702) 990-7711
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X B00457 NV Primary

Addresses

Primary practice location

715 Mall Ring Circle
Suite 205
Henderson, NV 89014

Mailing address

715 Mall Ring Circle
Suite 205
Henderson, NV 89014
Phone (702) 990-2225

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
B00457NVMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Spine & Rehabilitation Chiropractor PastSince Jan 1, 2008 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: roger.russell@425.chartlogic.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1912987397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 MALL RING CIRCLE",
            "address_2": "SUITE 205",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89014",
            "telephone_number": "702-990-2225",
            "fax_number": "702-990-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 MALL RING CIRCLE",
            "address_2": "SUITE 205",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89014",
            "telephone_number": "702-990-2225",
            "fax_number": "702-990-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ROGER",
        "middle_name": "ALAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B00457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.