Individual provider Active NPI

David B Russ, DC

  • Chiropractor
  • Portland, OR
National Provider Identifier
1942344221
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3117 Issued in OR
Practice address
1020 SW Taylor St
#330
Portland, OR 97205-2543
Phone
(503) 287-4970
Fax
(503) 221-5454
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3117 OR Primary

Addresses

Primary practice location

1020 SW Taylor St
#330
Portland, OR 97205-2543

Mailing address

7928 SE Madison St
Portland, OR 97215-3021
Phone (503) 754-6136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170127001904 OR Practitioner - Chiropractic 9537472337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3117ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Allbutter LLC Current Accepting new patients
Russ Family Chiropractic LLC Chiropractor CurrentSince Nov 20, 2016 Accepting new patients

Locations

1020 SW Taylor St
Ste 330
Portland, OR 97205
Phone (503) 287-4970

1717 NE 42nd Ave
Ste 3200
Portland, OR 97213
Phone (503) 489-8699

Organizations & group practices 2

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942344221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7928 SE MADISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153021",
            "telephone_number": "503-754-6136",
            "fax_number": "503-221-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SW TAYLOR ST",
            "address_2": "#330",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052543",
            "telephone_number": "503-287-4970",
            "fax_number": "503-221-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.