DR. RUSSELL D. RADICAN (NPI# 1528172368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528172368 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL D. RADICAN |
| Credential | DC |
| Practice Address |
6100 Primacy Pkwy Suite 105 Memphis TN 38119-0705 |
| Practice Telephone | 9016825335 |
| Practice Fax Number | 9016825440 |
| Mailing Telephone | 9016825335 |
| Mailing Fax Number | 9016825440 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 111NS0005X |
Chiropractor Specialization: Sports Physician |
DC1171 | TN | Chiropractic Providers |
| X | 111NX0100X |
Chiropractor Specialization: Occupational Health |
DC1171 | TN | Chiropractic Providers |
| X | 111NX0800X |
Chiropractor Specialization: Orthopedic |
DC1171 | TN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | CIGNA HMO | 61387800-04 | 01 |
| TN | AETNA HMO | 5829049 | 01 |
| TN | BLUECROSSBLUESHIELD | 3009201 | 01 |
| TN | CIGNA | 61387800-03 | 01 |
| Street Address |
6100 PRIMACY PKWY SUITE 105 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38119-0705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699774539 | Demetria Leonard Davis | Physician Assistant | 6100 Primacy Pkwy, Suite 112, Memphis, TN 38119-0705 | 2005-07-21 |
| 1821389784 | Erin B Meredith | Registered Nurse | 6100 Primacy Pkwy, Suite 105, Memphis, TN 38119-0705 | 2011-04-27 |
| 1437449170 | Memphis Pain Management Group, PC | Chiropractor | 6100 Primacy Pkwy, Suite 112, Memphis, TN 38119-0705 | 2011-04-14 |
| 1134450307 | Robert Larry Smith | Nurse Practitioner | 6100 Primacy Pkwy, Suite 112, Memphis, TN 38119-0705 | 2010-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417469628 | Jojuan Fullwiley | Behavioral Analyst | 6685 Quince Rd Ste 116, Memphis, TN 38119 | 2017-10-27 |
| 1336675297 | Jill Budynas Depriest | Counselor | 5583 Murray Ave Ste 203, Memphis, TN 38119 | 2017-05-11 |
| 1396279220 | Glen Matthew Stamps Jr. | Counselor | 5583 Murray Ave Ste 207, Memphis, TN 38119 | 2017-04-18 |
| 1598117442 | Hazel Aberdeen | Chiropractor | 1911 Memphis Tennessee, Memphis, TN 38119 | 2016-07-04 |
| 1831569060 | E-c-t Non Emergency Medical Transport | Non-emergency Medical Transport (VAN) | 6869 Woodlake Dr, Memphis, TN 38119 | 2015-09-30 |
| 1053781617 | Astrid Roman | Dietitian, Registered | 8020 Hillside Cv, Memphis, MS 38119 | 2015-09-25 |
| 1467857664 | Allan Jacob Katz | Counselor | 5668 Rex Rd, Suite 104, Memphis, TN 38119 | 2014-10-30 |
| 1962836015 | Judy Ann Harrick | Acupuncturist | 5575 Poplar Ave., #702, Memphis, TN 38119 | 2013-08-26 |
| 1366791949 | Jennifer Denyes Bidelman | Audiologist | 5625 Poplar Avenue, Memphis, TN 38119 | 2012-08-29 |
| 1578833620 | Elizabeth Mary Dion-douglass | Pharmacist | 2891 Kirby Parkway, Memphis, TN 38119 | 2012-01-06 |
| Find all providers in zip 38119 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619349388 | Back and Neck Specialists LLC | Chiropractor | 959 S White Station Rd, Memphis, TN 38117-5811 | 2015-10-21 |
| 1639433931 | Rupert Alan James | Chiropractor | 721 W Brookhaven Cir, Memphis, TN 38117-4503 | 2012-07-02 |
| 1992874721 | Rupert Alan James | Chiropractor | 5570 Murray Rd, Memphis, TN 38119-3805 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548619497 | Detweiler Chiropractic Health Services of Tn, Pllc | Chiropractor | 556 Trinity Creek Cv, Cordova, TN 38018-2279 | 2016-06-10 |
| 1427229343 | Rowan Chiropractic | Chiropractor | 2193 N Main St, Suite 103, Crossville, TN 38555-6737 | 2008-03-19 |
| 1790825149 | Christopher Dale Bennett | Chiropractor | 3018 South Mall Road, Knoxville, TN 37917 | 2007-02-07 |
| 1245392067 | Robert James Bussenger | Chiropractor | 1600 Bonnie Ln Ste 102, Cordova, TN 38016-0510 | 2006-12-15 |
| 1285792929 | Marco E. Castaneda | Chiropractor | 7786 Emory Chase Ln, Knoxville, TN 37918-6147 | 2006-12-05 |
| 1942306253 | Jeffrey Mckinley | Chiropractor | 358 Caldwell St, Mcminnville, TN 37110-2032 | 2006-09-15 |
| 1093826786 | Daniel Steven Giammo | Chiropractor | 11653 Chapman Hwy, Seymour, TN 37865-5099 | 2006-08-31 |
| 1801807698 | Samuel F Messimer | Chiropractor | 501 W Oakland Ave, Suite #3, Johnson City, TN 37604-1666 | 2006-08-10 |
| 1467410589 | Andrew Charles Rowan | Chiropractor | 28 Fountain Sq, Crossville, TN 38555-8790 | 2006-05-01 |
| 1710949722 | Joel W Durham | Chiropractor | 25 Corporate Blvd, Jackson, TN 38305-2314 | 2006-04-05 |
| Find all providers with the same taxonomy | ||||
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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.