Russell L Wavrin, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

244196 Issued in MN

Practice address

6545 France Ave S
Ste 540
Edina, MN 55435-2131

Phone

(952) 927-4045

Fax

(952) 924-4133

NPI assigned

Mar 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Infinite Health Collaborative, PA

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1164474250

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Obstetrics and Gynecology Associates, P.a.

  • Obstetrics & Gynecology Physician
  • Edina, MN
  • NPI 1871576116
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • Hudson, WI
  • NPI 1568840916
  NPD
• Diamond Women'S Center, P.a.

  • Obstetrics & Gynecology Physician
  • Edina, MN
  • NPI 1790873412
  NPD (past)

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1962479071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S",
            "address_2": "STE 540",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352131",
            "telephone_number": "952-927-4045",
            "fax_number": "952-924-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S",
            "address_2": "STE 540",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352131",
            "telephone_number": "952-927-4045",
            "fax_number": "952-924-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAVRIN",
        "first_name": "RUSSELL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "244196",
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MN",
            "license": "244196",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "18559WA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP14652",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055302600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Collins Watson
• Chad Christopher Watters, D.C.
• Kristen Watts, D.C.
• Daniel Alexander Wattson, MD
• Wave Forms Med Tech, LLC
• Joshua Gray Waytz, MD
• Paul Harvey Waytz, M.D.
• Terri Ann Weaver, OTR
• Corinne Marie Webb-Kay, MD
• Crispin J Webb, M.D.

• Obstetrics & Gynecology Physician in Edina, MN
• Providers in Edina, MN by specialty
• Obstetrics & Gynecology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.