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DR. KERRY BRUCE RUSSELL D.C. C.C.S.P. NPI 1093714222


NPI Information

NPI: 1093714222
Provider Name: DR. KERRY BRUCE RUSSELL, D.C., C.C.S.P.
Classification: Chiropractor - 111NS0005X
Entity Type: Individual

Specialization: Sports Physician

Address:
692 HANNAH AVE
SUITE A
TRAVERSE CITY, MI
ZIP 49686
Phone: (231) 947-2228
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DR. Kerry Bruce Russell, D.C., C.C.S.P. is a sports physician chiropractor in Traverse City, MI with 28 years of experience. The provider is 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. DR. Kerry Bruce Russell, D.C., C.C.S.P. NPI is 1093714222. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NATIONAL COLLEGE OF CHIROPRACTIC
Graduation Year:1996

The provider's business location address is:

692 HANNAH AVE
SUITE A
TRAVERSE CITY, MI
ZIP 49686-110
Phone: (231) 947-2228
Fax: (231) 947-2616

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Chiropractic manipulative treatment, 3 to 4 spinal regions (HCPCS:98941)

The enumeration date for this NPI number is 7/19/2005 and was last updated on 9/9/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111NS0005XChiropractorSports PhysicianKR007665MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ON50110MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
2611406599OTHERMICHIGANPPOM
3U72489OTHERMICHIGANPRIORITY HEALTH
4P99464OTHERMICHIGANBLUE CARE NETWORK
5950B850440OTHERMICHIGANBCBSM PPO
615934OTHERMICHIGANMCARE
7U72489MEDICARE UPINMICHIGAN
84417133MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.