Active NPI
Sheryl L Russell, DC
- Chiropractor
- Beverly, MA
National Provider Identifier
1952473530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH2065
- Practice address
- 319 Elliott St
Beverly, MA 01915 - Phone
- (978) 927-2607
- Fax
- (978) 927-2463
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH2065 | MA | Primary |
Addresses
Primary practice location
319 Elliott St
Beverly, MA 01915
Mailing address
319 Elliott St
Beverly, MA 01915
Phone (978) 927-2607
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 351127 | Other | HPHC | |
| Y36462 | Other | BCBS | |
| 1613006 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060425000053 | MA | Practitioner - Chiropractic | 2961412788 | Practice locations: Beverly, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
319 Elliott St
Beverly, MA 01915-2421
Phone (978) 927-2607
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH2065 | MA | MD | Chiropractor |
| 2065 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1952473530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 ELLIOTT ST",
"city": "BEVERLY",
"state": "MA",
"postal_code": "01915",
"telephone_number": "978-927-2607",
"fax_number": "978-927-2463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 ELLIOTT ST",
"city": "BEVERLY",
"state": "MA",
"postal_code": "01915",
"telephone_number": "978-927-2607",
"fax_number": "978-927-2463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "SHERYL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "CH2065",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC",
"identifier": "351127",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "Y36462",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1613006",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.