Derek Duncan Russell, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104555920 Issued in VA

Practice address

2125 McComas Way
Suite 101
Virginia Beach, VA 23456-3986

Phone

(757) 427-7690

Fax

(757) 427-7692

NPI assigned

Nov 24, 2006

Last updated

Jul 30, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Derek D. Russell, D.C., Inc.

  dba Nimmo Wellness

  • Chiropractor
  • Virginia Beach, VA
  • NPI 1639369291
  Medicare reassignment NPD Authorized official
• VB Chiropractic, PLC.

  • Chiropractor
  • Virginia Beach, VA
  • NPI 1689035461
  NPD
• Robert B Thoma DC PC

  • Chiropractor
  • Virginia Beach, VA
  • NPI 1831547371
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1922173822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 MCCOMAS WAY",
            "address_2": "SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563986",
            "telephone_number": "757-427-7690",
            "fax_number": "757-427-7692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 MCCOMAS WAY",
            "address_2": "SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563986",
            "telephone_number": "757-427-7690",
            "fax_number": "757-427-7692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DEREK",
        "middle_name": "DUNCAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "175426",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Rush
• Jennifer L Rush, DO
• Melissa Rush
• Allison Russell, LPC
• Charlotte Alexis Russell
• Joseph Russell
• Latonya Demetria Russell, MD, MPH
• Lori Ann Russell, LPTA
• Karen Harris Russo, RPH
• Olga L Russo

• Chiropractor in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.