Kimberly Ann Russell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0428043 Issued in KS

Practice address

12541 Foster St
Suite 300
Overland Park, KS 66213-2630

Phone

(913) 317-3200

Fax

(913) 317-3218

NPI assigned

May 17, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1962455592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E. 104TH ST.",
            "address_2": "MAILSTOP 400N",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314517",
            "telephone_number": "816-502-7104",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12541 FOSTER ST",
            "address_2": "SUITE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132630",
            "telephone_number": "913-317-3200",
            "fax_number": "913-317-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0428043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100339820C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandyn Marie Russell, OTR/L
• Carol Lynn Russell, CRNA
• Emily Luann Russell
• Hailey Russell
• Katherine Russell
• Lester Russell, RBT
• Rachael Marie Rutter, MS, LMFT
• RX Savings, LLC
• Ryan Family Chiropractic, LLC
• Anastasiaekaterina Ryan

• Family Medicine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.