DR. JOHN J RUSSELL (NPI# 1124098728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124098728 |
| Entity Type | Individual |
| Full Name | DR. JOHN J RUSSELL |
| Credential | M.D. |
| Practice Address |
1610 N Kings Highway St Suite 304 Cape Girardeau MO 63701-2196 |
| Practice Telephone | 5733352191 |
| Practice Fax Number | 5733355524 |
| Mailing Telephone | 5733352191 |
| Mailing Fax Number | 5733355524 |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2015-01-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 100521 | MO | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 100521 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BLUE CROSS BLUE SHIELD | 125591 | 01 |
| MO | RAILROAD MEDICARE | 370018381 | 01 |
| MO | 203340815 | 05 | |
| MO | HEALTHLINK | 178739 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821231663 | John Russell IIi | Dentist | 206 N Brookmoore Dr, Columbus, MS 39705-2020 | 2009-04-09 |
| 1417106196 | John Edwin Russell | Physical Medicine & Rehabilitation | 6455 Toucan Trl, Spring Hill, FL 34607-2642 | 2008-09-17 |
| 1831221159 | John Clark Russell | Dentist | 2010 Court St, Beatrice, NE 68310-3209 | 2007-03-12 |
| 1811023963 | John Thomas Russell | Dentist | 1116 West St, Suite B, Annapolis, MD 21401-3608 | 2007-02-25 |
| 1003957515 | John Wesley Russell | Dentist | 3253 Mccracken St, Muskegon, MI 49441 | 2007-02-08 |
| 1902958077 | John Douglas Russell | Dentist | 4178 Ashby Court, Shasta Lake City, CA 96019 | 2007-01-17 |
| 1619066156 | John Grover Russell | Specialist | 8188 W Bartlett Rd, Casa Grande, AZ 85222-7336 | 2006-10-12 |
| 1003918137 | John C Russell | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2731 Oak Bluff, San Antonio, TX 78230 | 2006-09-01 |
| 1720013204 | John Russell | Urology | 22 Hartford St # Sr, Houlton, ME 04730-1844 | 2006-07-12 |
| 1619925294 | John Andrew Haws Russell | Obstetrics & Gynecology | 106 Liner Dr, Greenwood, SC 29646 | 2006-05-05 |
| Street Address |
1610 N KINGS HIGHWAY ST SUITE 304 |
| City | CAPE GIRARDEAU |
| State | MO |
| Zip Code | 63701-2196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748110 | Westbrook Dialysis, LLC | Clinic/Center | 140 West Drive, Cape Girardeau, MO 63701 | 2020-10-22 |
| 1972079580 | Savannah Laine Menard | Behavior Technician | 20 S. Sprigg St, Cape Girardeau, MO 63701 | 2018-10-22 |
| 1932690377 | Broadway Specialty, LLC | Pharmacy | 706 Broadway St, Cape Girardeau, MO 63701 | 2018-05-22 |
| 1356864649 | Terri L. Mccord | Pharmacist | 4170 Connor Dr, Cape Girardeau, MO 63701 | 2017-07-19 |
| 1013459312 | Christina Cossou | Nurse Practitioner | 2116 Megan Dr Ste 102, Cape Girardeau, MO 63701 | 2016-11-17 |
| 1124573365 | Ashley Sullivan | Massage Therapist | 3041 Melrose Ave, Cape Girardeau, MO 63701 | 2016-08-17 |
| 1225432172 | Axpm - Merkley, LLC | Dentist | 2116 Megan Dr., Suite 101, Cape Girardeau, MO 63701 | 2014-10-21 |
| 1639573397 | Marian Perez Hurt | Physical Therapist | 2001 N. Kingshighway, Fountainbleau Lodge, Cape Girardeau, MO 63701 | 2014-10-09 |
| 1891194213 | Deanna Abner | Case Manager/Care Coordinator | 20 South Sprigg, Cape Girardeau, MO 63701 | 2014-08-21 |
| 1831506880 | Kwadwo O Britwum | Behavioral Analyst | Morningstar Behavioral Associates, 338 W. Broadway Suite 301, Cape Girardeau, MO 63701 | 2014-07-22 |
| Find all providers in zip 63701 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366524472 | Gary S. Olson | Pediatrics | 35 Doctors Park, Cape Girardeau, MO 63703-4927 | 2006-10-19 |
| 1942556089 | Jean Paula Diemer | Pediatrics | 3250 Gordonville Rd, Suite 301, Cape Girardeau, MO 63703-5056 | 2012-07-26 |
| 1679861785 | Chelsea Nicole Grigery | Pediatrics | 25 Doctors Park, Cape Girardeau, MO 63703-4927 | 2011-07-11 |
| 1346534351 | Kali D Francis | Pediatrics | 25 Doctors Park, Cape Girardeau, MO 63703-4927 | 2011-06-07 |
| 1295048411 | Amjad Taha | Pediatrics | 1701 Lacey St, Cape Girardeau, MO 63701-5230 | 2010-07-16 |
| 1245479419 | Greg Edward Cugini | Pediatrics | 25 Doctors Park, Cape Girardeau, MO 63701 | 2009-02-11 |
| 1609041052 | Alan R Barnette | Pediatrics | 211 Saint Francis Dr, Cape Girardeau, MO 63703-5049 | 2008-04-28 |
| 1609895481 | James E Hoffman | Pediatrics | 3250 Gordonville Rd, Ste 301, Cape Girardeau, MO 63703-5056 | 2006-07-19 |
| 1962432526 | Heather K Dodson | Pediatrics | 3250 Gordonville Rd, Ste 301, Cape Girardeau, MO 63703-5056 | 2006-07-03 |
| 1821026543 | Beverly Brown | Pediatrics | 3250 Gordonville Rd, Ste 301, Cape Girardeau, MO 63703-5056 | 2006-06-29 |
| Find all providers in CAPE GIRARDEAU | ||||
| City | CAPE GIRARDEAU |
| Zip Code | 63701 |
Please comment or provide details below to improve the information on DR. JOHN J RUSSELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.