DR. KEVIN JOSEPH RUSSELL (NPI# 1194905257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194905257 |
| Entity Type | Individual |
| Full Name | DR. KEVIN JOSEPH RUSSELL |
| Credential | O.D. |
| Practice Address |
2048 E. Baseline Rd. Suite C6 Mesa AZ 85204 |
| Mailing Address |
23490 S. 201st St. Queen Creek AZ 85142 |
| Practice Telephone | 4802458929 |
| Practice Fax Number | 4805070836 |
| Mailing Telephone | 4802458929 |
| Mailing Fax Number | 4805070836 |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2018-04-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 779 | AZ | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558759480 | Kevin D Russell Sr. | Driver | 1351 Gates Rd, Columbia, MS 39429-8948 | 2014-12-30 |
| 1598065070 | Kevin E Russell | Pharmacist | 3308 Nw Southview Dr, Albany, OR 97321 | 2010-10-29 |
| 1558592675 | Kevin Leigh Russell | Military Health Care Provider | Msron-6, Bldg 15, Norfolk Naval Shipyard, Portsmouth, VA 23709 | 2009-08-06 |
| 1366543167 | Kevin John Russell | Counselor | 5435 Bull Valley Rd Ste 106, Mchenry, IL 60050-2209 | 2006-09-26 |
| 1851899694 | Kevin Laron Russell | Behavior Technician | 75 Park Creek Dr, Clovis, CA 93611-4432 | 2018-01-26 |
| 1659512978 | Kevin Russell | Marriage & Family Therapist | 1030 2nd St, Santa Rosa, CA 95404-6607 | 2009-03-17 |
| 1780722868 | Kevin L. Russell | Preventive Medicine | 34800 Bob Wilson Dr, Nmcsd, San Diego, CA 92134-1098 | 2007-02-02 |
| 1881601318 | Kevin T Russell | Physical Therapist | 111 Goose Lane, Ste 2500, Guilford, CT 06437 | 2006-08-01 |
| Street Address |
2048 E. BASELINE RD. SUITE C6 |
| City | MESA |
| State | AZ |
| Zip Code | 85204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610302 | West Point Optical Group | Optometrist | 10706 E Point Twenty-two Blvd, #107, Mesa, AZ 85212 | 2020-08-18 |
| 1053939306 | Corey Dunlop | Optometrist | 1025 S Power Rd Ste 102, Mesa, AZ 85206-5240 | 2020-07-13 |
| 1275001927 | Arizona Vision of Mesa | Optometrist | 1425 S Alma School Rd Ste 103, Mesa, AZ 85210-2000 | 2018-11-09 |
| 1538681762 | Kelsey Lynn Roumfort | Optometrist | 1303 S Longmore Ste 2, Mesa, AZ 85202-9607 | 2017-07-10 |
| 1629520663 | Tom Sowash Od & Associates, PC | Optometrist | 1826 S Signal Butte Rd, Suite 101, Mesa, AZ 85209-2730 | 2016-10-25 |
| 1235594391 | Trusight Optometry, LLC | Optometrist | 6525 E Southern Ave, Mesa, AZ 85206-3711 | 2015-12-16 |
| 1720419534 | Todd Christian Brown | Optometrist | 8435 E Baseline Rd Bldg C, Mesa, AZ 85209-4379 | 2013-12-03 |
| 1154692226 | Mesa Vision Partners,pllc | Optometrist | 937 N Dobson Rd, Ste 102, Mesa, AZ 85201-7588 | 2012-01-22 |
| 1649553355 | Elena Filatova | Optometrist | 1423 S Higley Rd Ste 104, Mesa, AZ 85206-3449 | 2011-09-20 |
| 1962784975 | Blaine Kenneth Watkins | Optometrist | 1155 S Power Rd, Suite 102, Mesa, AZ 85206-3715 | 2011-09-15 |
| Find all providers in MESA | ||||
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| 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.