DR. TRENT K RUSSELL (NPI# 1134115744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134115744 |
| Entity Type | Individual |
| Full Name | DR. TRENT K RUSSELL |
| Credential | M.D. |
| Practice Address |
1057 Medical Park Dr Suite A Osage Beach MO 65065-3050 |
| Mailing Address |
54 Hospital Dr Osage Beach MO 65065-3050 |
| Practice Telephone | 5733482745 |
| Practice Fax Number | 5733488279 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2008-05-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 107627 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | RAILROAD MEDICARE | 370013633 | 01 |
| MO | 208072900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457630642 | Trent Russell | Physician Assistant | 5444 Green St, Murray, UT 84123-5632 | 2011-08-05 |
| Street Address |
1057 MEDICAL PARK DR SUITE A |
| City | OSAGE BEACH |
| State | MO |
| Zip Code | 65065-3050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477559490 | Mark R Jones | Family Medicine | 1057 Medical Park Dr, Suite A, Osage Beach, MO 65065 | 2005-06-23 |
| 1376957415 | Catharine Kahrig | Nurse Practitioner | 1057 Medical Park Dr, Osage Beach, MO 65065 | 2014-06-17 |
| 1447542303 | Marcia Patricia Roye-madison | Nurse Practitioner | 1057 Medical Park Dr, Ste A, Osage Beach, MO 65065-3000 | 2011-05-11 |
| 1245520691 | Lake Regional Health System | Clinic/Center | 1057 Medical Park Dr, Suite A, Osage Beach, MO 65065-3000 | 2011-04-19 |
| 1467683961 | Kristen Marie Eblen | Pharmacist | 1057 Medical Park Dr, Suite B, Osage Beach, MO 65065-3000 | 2009-07-31 |
| 1144451774 | John Carlyn Brand | Family Medicine | 1057 Medical Park Dr, Osage Beach, MO 65065-3000 | 2009-07-30 |
| 1982833885 | Jason Scott Hagely | Pediatrics | 1057 Medical Park Dr, Osage Beach, MO 65065-3000 | 2009-07-13 |
| 1720288236 | Heidi C Calipjo | Family Medicine | 1057 Medical Park Dr, Suite A, Osage Beach, MO 65065-3000 | 2007-07-23 |
| 1174659262 | Lake Orthopedic Group, Inc. | Orthopaedic Surgery | 1057 Medical Park Dr, Suite C, Osage Beach, MO 65065 | 2007-02-26 |
| 1275577926 | Randall C Barnes | Family Medicine | 1057 Medical Park Dr, Suite A, Osage Beach, MO 65065-3000 | 2006-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778859 | Suzanne Marie Harris | Social Worker | 1191 State Highway Kk, Suite 101, Osage Beach, MO 65065 | 2020-04-15 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1245723337 | William T Mcfail | Counselor | 1191 State Hwy Kk, Suite 101, Osage Beach, MO 65065 | 2018-06-13 |
| 1588102263 | Jennifer Kiske | Physical Therapist | 5780 Osage Beach Parkway, Ste 220, Osage Beach, MO 65065 | 2017-02-02 |
| 1700207586 | Brenda Renee Spies | Pharmacist | 4252 Osage Beach Parkway, Osage Beach, MO 65065 | 2013-12-23 |
| 1154668465 | Paige Hedgpath Od, PC | Optometrist | 4645g Osage Beach Parkway, Osage Beach, MO 65065 | 2013-01-07 |
| 1649548330 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 300 Kestrel Lane, Lake Ozark, MO 65065 | 2011-12-08 |
| 1437399821 | Melissa Nicole Morgan | Physical Therapy Assistant | 5177 Vicus Castri, Osage Beach, MO 65065 | 2009-02-25 |
| 1730330911 | Raymond Don Baker | Preventive Medicine | 5476 Stone Ledge Cir, Osage Beach, MO 65065 | 2008-10-06 |
| 1457514259 | Lake Family Dentistry | Dentist | 1037 Palisades Blvd Ste 9, Osage Beach, MO 65065 | 2008-07-02 |
| Find all providers in zip 65065 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235138330 | Maria E. Bernabe | Pediatrics | 931 Highway D, Osage Beach, MO 65065-3169 | 2005-07-20 |
| 1982833885 | Jason Scott Hagely | Pediatrics | 1057 Medical Park Dr, Osage Beach, MO 65065-3000 | 2009-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114537222 | Natalie Joan Wilson | Pediatrics | 1463 Us Hwy 61, Suite C, Festus, MO 63028-6302 | 2020-08-04 |
| 1538786413 | Melissa An | Pediatrics | 1 Childrens Pl Ste 3s36, Saint Louis, MO 63110-1002 | 2020-06-26 |
| 1033731500 | Jessica N Zeiss | Pediatrics | 981 Highway K, Rhineland, MO 65069-2214 | 2020-05-07 |
| 1538795547 | Virtualnicu | Pediatrics | 10 Warridge Dr, Saint Louis, MO 63124-1166 | 2020-03-21 |
| 1811528656 | Children's Mercy-cockerell and Mcintosh Pediatrics, Inc | Pediatrics | 205 Nw R D Mize Rd Ste 304, Blue Springs, MO 64014-2520 | 2020-01-30 |
| 1134780430 | Jane Reardon | Pediatrics | 8140 Ward Pkwy Ste 275, Kansas City, MO 64114-2032 | 2019-06-26 |
| 1174082887 | Kristen Steinmeyer | Pediatrics | 714 Peace Haven Ct, Saint Louis, MO 63125-5404 | 2019-03-13 |
| 1023574365 | Saint Francis Medical Center | Pediatrics | 2210 Barron Rd Ste 120, Poplar Bluff, MO 63901-1908 | 2019-02-12 |
| 1215402011 | Ayse Bahar Budan Caliskan | Pediatrics | Washington University, St. Louis Children's Hospital, One Children's Place, 4n1, St. Louis, MO 63110-1002 | 2018-10-08 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
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| City | OSAGE BEACH |
| Zip Code | 65065 |
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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.