Russell Lynn Vollmer, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

286822-3501 Issued in UT

Practice address

215 E 50 S Ste 5
Malad City, ID 83252-2300

Phone

(208) 766-2365

Fax

(208) 766-2364

NPI assigned

May 8, 2014

Last updated

Mar 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

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.

• Catholic Health Initiatives Colorado

  dba Behavioral Health West Valley

  • Prescribing (Medical) Psychologist
  • West Valley City, UT
  • NPI 1942903562
  Medicare reassignment Care Compare group NPD
• T Help

  dba Sanctuary NTC

  • Community/Behavioral Health Agency
  • Chubbuck, ID
  • NPI 1649607250

  Clinical

  Medicare reassignment NPD
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• Catholic Health Initiatives Colorado

  dba Cardiology Jordan Valley

  • Cardiovascular Disease Physician
  • West Jordan, UT
  • NPI 1245932318
  NPD
• Catholic Health Initiatives Colorado

  dba CommonSpirit Orthopedics Longmont

  • Orthopaedic Surgery Physician
  • Longmont, CO
  • NPI 1891675294
  NPD

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1962813253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2672 N 3100 W",
            "city": "MALAD CITY",
            "state": "ID",
            "postal_code": "832526519",
            "telephone_number": "208-637-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 50 S STE 5",
            "city": "MALAD CITY",
            "state": "ID",
            "postal_code": "832522300",
            "telephone_number": "208-766-2365",
            "fax_number": "208-766-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLMER",
        "first_name": "RUSSELL",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "286822-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-36911",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LSW-28623",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "UT",
            "license": "286822-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dallas R Spencer, LMSW
• Summit Creek Counseling LLC
• Ariel Shantay Avis Taysom, PA-C
• Edgar Blair Thorpe, DDS
• Valley View Counseling LLC
• Micah Weber, PT, DPT
• Joshua Price Wray

• Social Worker in Malad City, ID
• Providers in Malad City, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.
• 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.