Individual provider Active NPI

Robert Blaine Russell, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Cape Girardeau, MO
National Provider Identifier
1992814966
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
R6D82 Issued in MO
Practice address
1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone
(573) 335-0185
Fax
(573) 335-0793
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R6D82 MO
Critical Care Medicine (Anesthesiology) Physician 207LC0200X R6D82 MO
Pain Medicine (Anesthesiology) Physician 207LP2900X R6D82 MO Primary

Addresses

Primary practice location

1701 Lacey St
Cape Girardeau, MO 63701-5230

Mailing address

721 N Sunset Blvd
Cape Girardeau, MO 63701-4532

Other identifiers 2

IdentifierTypeStateIssuer
105181OtherMOBLUE CROSS BLUE SHIELD
178715OtherHEALTHLINK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R6D82MOMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Cape Girardeau PC Anesthesiology PastSince Apr 1, 2009 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1992814966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 N SUNSET BLVD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 LACEY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637015230",
            "telephone_number": "573-335-0185",
            "fax_number": "573-335-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ROBERT",
        "middle_name": "BLAINE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "R6D82",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MO",
            "license": "R6D82",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "R6D82",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "105181",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "178715",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.