David Ray Russell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

293T Issued in WY

Practice address

720 6TH St
Evanston, WY 82930

Phone

(307) 789-1500

Fax

(307) 789-0077

NPI assigned

Oct 2, 2006

Last updated

Aug 2, 2018By 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 1

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• David R Russell OD

  dba Accurate Eye Care

  • Optometrist
  • Evanston, WY
  • NPI 1700076643
  Medicare reassignment NPD Authorized official
• CBS Vision Inc.

  dba Mountain Valley Eye Institute

  • Ophthalmology Physician
  • Park City, UT
  • NPI 1518549245
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1992898894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 6TH ST",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829303702",
            "telephone_number": "307-789-1500",
            "fax_number": "307-789-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 6TH ST",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "82930",
            "telephone_number": "307-789-1500",
            "fax_number": "307-789-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DAVID",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "293T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1219545 00",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Auburn Amanda Robertson, LMFT
• Michelle A Robertson, M.A.
• Shontay Marie Roe, LCSW
• Eric G Roman, NP
• Pennie Roussin
• Linda Gail Sandness, BA. NCACII LAT LAT-1
• Roger Nelson Scarborough, MS
• Nathan C Schafer, M.D.
• Brian Schaffer
• Emily Scott

• Optometrist in Evanston, WY
• Providers in Evanston, WY by specialty
• Optometrist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.