DR. LISA MARIE RUSSELL (NPI# 1700150976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700150976 |
| Entity Type | Individual |
| Full Name | DR. LISA MARIE RUSSELL |
| Credential | D.M.D. |
| Practice Address |
655 Clinic Rd Suite 110 Hannibal MO 63401-3647 |
| Practice Telephone | 5732210001 |
| Mailing Telephone | 5732210001 |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
2011028140 | MO | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730514316 | Lisa Dawn Russell | Nurse Practitioner | 1343 County Road 1450 E, Carmi, IL 62821-5205 | 2013-09-13 |
| 1710290671 | Lisa R Russell | Occupational Therapist | 3999 Whispering Trails Ct, Hoffman Estates, IL 60192-1547 | 2010-07-21 |
| 1821614371 | Lisa Evealine Russell | Day Training/Habilitation Specialist | 804 Industrial Park Rd, Maxwelton, WV 24957-8066 | 2020-06-21 |
| 1154774651 | Lisa Russell | Midwife | 4222 Mcintosh Ln, Sarasota, FL 34232-5027 | 2016-07-20 |
| 1467806406 | Lisa Russell | Specialist/Technologist, Other | 200 7th Ave, Suite 150, Santa Cruz, CA 95062-4668 | 2016-04-15 |
| 1871974865 | Lisa Pearse Russell | Nurse Practitioner | 346 Maine St, Lawrence, KS 66044-1393 | 2015-06-15 |
| 1639500937 | Lisa Russell | Physical Therapist | 555 Amory St, Jamaica Plain, MA 02130-2652 | 2013-12-12 |
| 1649509498 | Lisa Marie Russell | Pharmacist | 1250 S Wheeler St, Jasper, TX 75951-5120 | 2009-12-08 |
| 1225108046 | Lisa A Russell | Physical Therapy Assistant | 1204 Frye St, Athens, TN 37303 | 2006-11-09 |
| 1760551212 | Lisa Michelle Russell | Massage Therapist | 1803 Miccosukee Commons Dr, Ste 202, Tallahassee, FL 32308 | 2006-11-07 |
| Street Address |
655 CLINIC RD SUITE 110 |
| City | HANNIBAL |
| State | MO |
| Zip Code | 63401-3647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902090400 | Brent C Smola, PC | Chiropractor | 655 Clinic Rd, Ste. 205, Hannibal, MO 63401-3647 | 2007-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255981064 | Amanda Lynn Jennings | Nurse Practitioner | Hannibal Clinic, 100 Medical Drive, Hannibal, MO 63401 | 2019-09-13 |
| 1316452295 | Hannibal Regional Healthcare System, Inc | Hospice Care, Community Based | 6401 Hwy Mm, Hannibal, MO 63401 | 2017-12-13 |
| 1932614351 | Sidney M Johnson | Counselor | 1221 Broadway St, Hannibal, MO 63401 | 2017-12-07 |
| 1316467210 | Jessica Baker | Counselor | 4355 Paris Gravel Road, Hannibal, MO 63401 | 2017-06-21 |
| 1346787066 | Hands Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 Settlerstrail, Hannibal, MO 63401 | 2017-01-20 |
| 1134571672 | Pamela Barrigar | Social Worker | 4600 Mcmasters Ave, Hannibal, MO 63401 | 2016-07-08 |
| 1639540677 | Jessica Murfin | Speech-Language Pathologist | 544 N Veterans Rd, Hannibal, MO 63401 | 2015-10-16 |
| 1366835639 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 8965 Highway 36 Ste 3, Hannibal, MO 63401 | 2015-03-11 |
| 1639324254 | Hannibal Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 118 Steam Boat Bend, Hannibal, MO 63401 | 2008-11-24 |
| 1780856112 | Barbara Belle Smith | Social Worker | 3700 Hwy Mm, Hannibal, MO 63401 | 2008-03-26 |
| Find all providers in zip 63401 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649878034 | Soh of Missouri Samson Liu PC | Dentist | 810 Ofallon Rd Ste 70, Weldon Spring, MO 63304-8107 | 2020-10-16 |
| 1952918054 | Candid Missouri, LLC | Dentist | 7431 Broadway, Kansas City, MO 64114-1529 | 2020-09-23 |
| 1659915098 | Cheif Smiles LLC | Dentist | 620 E. Us Highway 40, Blue Springs, MO 64014 | 2019-10-29 |
| 1780140459 | Evan W Brown Dds Inc | Dentist | 160 Four Seasons Shopping Ctr, Chesterfield, MO 63017-3104 | 2019-02-18 |
| 1376014852 | Catherine Loner | Dentist | 1470 S New Florissant Rd, Florissant, MO 63031-8198 | 2018-12-10 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1699281121 | St Louis South Orthodontics | Dentist | 9911 Kennerly Rd Ste H, Saint Louis, MO 63128-2700 | 2017-12-20 |
| 1023557766 | Uncommon Orthodontics By William A. Pickard, Dds, Ms, Pllc | Dentist | 2330 S Range Line Rd Ste E, Joplin, MO 64804-3267 | 2017-02-14 |
| 1023556743 | Mark Humphrey | Dentist | 8657 Old Bonhomme Rd, Saint Louis, MO 63132-3901 | 2017-02-01 |
| 1912458688 | Jerry F. Cash | Dentist | 2844 S Ingram Mill Rd, Springfield, MO 65804-4042 | 2016-10-18 |
| 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.