RUSSELL L ELLIS (NPI# 1134292766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134292766 |
| Entity Type | Individual |
| Full Name | RUSSELL L ELLIS |
| Credential | MD |
| Practice Address |
1103 16th Ave Se Decatur AL 35601-3595 |
| Practice Telephone | 2563500362 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2007-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
00022020 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BLUECROSS BLUESHIELD OF A | 51507394 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053335869 | Russell Ellis | Dentist | 3004 Emmorton Rd, Abingdon, MD 21009-2024 | 2006-07-26 |
| 1568430627 | Russell Lance Ellis | Chiropractor | 9029 Reseda Blvd, Suite 206, Northridge, CA 91324-3932 | 2006-03-14 |
| Street Address |
1103 16TH AVE SE |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-3595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104904903 | Phillip Shannon Farris | Physician Assistant | 1103 16th Ave Se, Decatur, AL 35601-3595 | 2006-11-01 |
| 1962036665 | Krista Butts | Nurse Practitioner | 1103 16th Ave Se, Decatur, AL 35601-3595 | 2020-03-03 |
| 1295240588 | Eric Todd Smith | Technician/Technologist | 1103 16th Ave Se, Decatur, AL 35601-3595 | 2017-12-07 |
| 1679095699 | Jeremy Keith Urban | Nurse Practitioner | 1103 16th Ave Se, Decatur, AL 35601 | 2017-07-11 |
| 1699169474 | Nicholas Krishnan | Physician Assistant | 1103 16th Ave Se, Decatur, AL 35601-3595 | 2015-03-19 |
| 1841633187 | Justin David Hallock | Orthopaedic Surgery | 1103 16th Ave Se, Decatur, AL 35601-3595 | 2013-04-16 |
| 1073854626 | Meghan Pace Hollimon | Nurse Practitioner | 1103 16th Ave Se, Decatur, AL 35601-3595 | 2013-03-06 |
| 1902045867 | Janice D Draper | Physical Therapist | 1103 16th Ave Se, Decatur, AL 35601-3595 | 2009-02-16 |
| 1215198007 | Justin L Daigre | Specialist | 1103 16th Ave Se, Decatur, AL 35601-3595 | 2008-06-24 |
| 1023234648 | Charles Edward Fortenberry | Nurse Practitioner | 1103 16th Ave Se, Decatur, AL 35601-3595 | 2007-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437543394 | Decatur Ortho-neuro Group LLC | Physical Medicine & Rehabilitation | 1376 Church St, Decatur, GA 30030-1519 | 2015-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760046312 | Josh Rogers | Physical Medicine & Rehabilitation | 1452 Marshall Rd, Rainsville, AL 35986-4327 | 2019-04-30 |
| 1942770532 | Daniel Rohrer | Physical Medicine & Rehabilitation | 30762 Al-181, Spanish Fort, AL 36527 | 2018-11-27 |
| 1780152108 | Tyler Scott Allison | Physical Medicine & Rehabilitation | 317 5th St Ne, Fayette, AL 35555-2009 | 2018-11-03 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1972017044 | Madison County Medical Center LLC | Physical Medicine & Rehabilitation | 13971 Highway 231 431 N, Hazel Green, AL 35750-8651 | 2017-11-27 |
| 1548779911 | Anna Rebekah Talbot | Physical Medicine & Rehabilitation | 1 Harrison Plaza, Florence, AL 35632 | 2017-09-28 |
| 1538684329 | Josh Penny | Physical Medicine & Rehabilitation | 1 Champions Way, Florence, AL 35632-0001 | 2017-08-14 |
| 1336676352 | Matthew Michael Hanks | Physical Medicine & Rehabilitation | 1228 Haley Ctr, Auburn, AL 36849-0001 | 2017-05-22 |
| 1760915748 | Phenix City Joint & Rehab, LLC | Physical Medicine & Rehabilitation | 3700 S Railroad St Ste C, Phenix City, AL 36867-2994 | 2017-04-06 |
| 1386079739 | Thomas Daniel Eck | Physical Medicine & Rehabilitation | 48 Market Square, Rogersville, AL 35652 | 2013-09-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RUSSELL L ELLIS.
| 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.