Michael A Russell, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3307 Issued in OH

Practice address

18624 Detroit Ave
Lakewood, OH 44107-3202

Phone

(216) 221-1788

Fax

(216) 221-2820

NPI assigned

Sep 22, 2006

Last updated

Mar 6, 2012By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Russell Chiropractic LTD

  • Chiropractor
  • Lakewood, OH
  • NPI 1467622480
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1962502880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18624 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073202",
            "telephone_number": "216-221-1788",
            "fax_number": "216-221-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18624 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073202",
            "telephone_number": "216-221-1788",
            "fax_number": "216-221-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "3307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000232365",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2321553",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence M Roth, LSW, CDCA
• Elizabeth Ruiz
• Joyce M Rusnak, SLP
• Russell Chiropractic LTD
• Anna Russell
• Whit Ryan, PSYD
• Isabella Rybak
• Barbara A. Sabol, S.T.
• Saferides Ambulette LTD.
• Pamela Sue Salasek, RPH

• Chiropractor in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.

Verify at the official NPI Registry.