Russell Gene Boester, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-022146 Issued in IL

Practice address

513 N Main St
Anna, IL 62906-1697

Phone

(618) 833-4471

NPI assigned

Jul 17, 2006

Last updated

Apr 21, 2022By 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

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

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.

• Rural Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Anna, IL
  • NPI 1982666384
  Medicare reassignment NPD
• Rural Health, Inc.

  dba Rural Health Plus

  • Community/Retail Pharmacy
  • Anna, IL
  • NPI 1801634183
  NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1982621686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 N MAIN ST",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629061697",
            "telephone_number": "618-833-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 N MAIN ST",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629061697",
            "telephone_number": "618-833-4471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 Truemper St",
            "address_purpose": "LOCATION",
            "city": "Jbsa Lackland",
            "state": "TX",
            "postal_code": "782365511",
            "country_code": "US",
            "telephone_number": "210-292-0770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOESTER",
        "first_name": "RUSSELL",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-022146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy L Bass
• Steven M Beatty, M.D.
• Danece Lynn Bennett, APRN
• Tessa Lea Binversie, D.C.
• Randall D Boen, MS, CRC, LCPC
• Richard Bolton
• Kimberly Sue Booker, PT
• Richard D Borders, LCSW
• Nicole Bouiilet
• Leeann Brandt, PA-C

• General Practice Dentistry in Anna, IL
• Providers in Anna, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.