Russel Brick McKelway, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101038662 Issued in VA

Practice address

1 West Main Street
Berryville, VA 22611-1340

Phone

(540) 667-1230

Fax

(540) 277-2174

NPI assigned

Aug 1, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: russell.mckelway.1@13270.direct.athenahealth.com

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.

• Hava Oaks Medical, LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Berryville, VA
  • NPI 1972268753
  NPD
• Birthinmind, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Winchester, VA
  • NPI 1801285598
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1942216775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WEST MAIN STREET",
            "city": "BERRYVILLE",
            "state": "VA",
            "postal_code": "226111340",
            "telephone_number": "540-667-1230",
            "fax_number": "540-277-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WEST MAIN STREET",
            "city": "BERRYVILLE",
            "state": "VA",
            "postal_code": "226111340",
            "telephone_number": "540-667-1230",
            "fax_number": "540-277-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELWAY",
        "first_name": "RUSSEL",
        "middle_name": "BRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101038662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "075075",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7135424",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "74722",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine L. Macdonnell, PT
• Janet Michelle Mackenzie, PH.D.
• Vicki S. Mainello, PTA
• Nicole Christine Malony, D.D.S.
• Phillip Marsh
• Tara Jo Moyer, IBCLC
• Ashley Neumann, DPT, PT
• New Insights, LLC
• Nancy Leigh Nine, MSW
• Beth Ann Norvell

• Psychiatry Physician in Berryville, VA
• Providers in Berryville, VA by specialty
• Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.