NPIMap

Organization Active NPI

Russell B Caldwell MD PC

  • Dermatology Physician
  • Bellevue, WA
National Provider Identifier
1962500181
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD00015594 Issued in WA
Legal business name
RUSSELL B CALDWELL MD PC
Practice address
1810 116TH Ave NE
Suite 100
Bellevue, WA 98004-3058
Phone
(425) 455-2276
Fax
(425) 455-1511
NPI assigned
Sep 20, 2006
Last updated
Jul 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Authorized official

Name
Russell B Caldwell, MDNPI 1831166404
Title
President/Owner
Phone
(425) 454-7546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MD00015594 WA Primary

Addresses

Primary practice location

1810 116TH Ave NE
Suite 100
Bellevue, WA 98004-3058

Mailing address

1810 116TH Ave NE
Suite 100
Bellevue, WA 98004-3058
Phone (425) 455-2276

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1962500181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 116TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043058",
            "telephone_number": "425-455-2276",
            "fax_number": "425-455-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 116TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043058",
            "telephone_number": "425-455-2276",
            "fax_number": "425-455-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL B CALDWELL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "425-454-7546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00015594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.