NPIMap

Organization Active NPI

Russell Chiropractic LLC

  • Chiropractor
  • O Fallon, MO
National Provider Identifier
1962656777
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2008002546 Issued in MO
Legal business name
RUSSELL CHIROPRACTIC LLC
Practice address
2161 W Terra LN
O Fallon, MO 63366-2366
Phone
(636) 887-9003
Fax
(636) 327-6090
NPI assigned
Nov 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Authorized official

Name
Dr. Travis Alan Russell, D.C.
Title
Dr. of Chiropractic
Phone
(314) 604-5761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2008002546 MO Primary

Addresses

Primary practice location

2161 W Terra LN
O Fallon, MO 63366-2366

Mailing address

2161 W Terra LN
O Fallon, MO 63366-2366
Phone (636) 887-9003

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1962656777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2161 W TERRA LN",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662366",
            "telephone_number": "636-887-9003",
            "fax_number": "636-327-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2161 W TERRA LN",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662366",
            "telephone_number": "636-887-9003",
            "fax_number": "636-327-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "DR. OF CHIROPRACTIC",
        "authorized_official_telephone_number": "314-604-5761",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2008002546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.