DR. RYAN MICHAEL RUSSELL (NPI# 1245465467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245465467 |
| Entity Type | Individual |
| Full Name | DR. RYAN MICHAEL RUSSELL |
| Credential | PHARMD. |
| Practice Address |
12266 De Paul Dr Suite 105 Bridgeton MO 63044-2514 |
| Mailing Address |
2911 Russell Blvd Saint Louis MO 63104-1536 |
| Practice Telephone | 3143447300 |
| Practice Fax Number | 3143447179 |
| Mailing Telephone | 3147713269 |
| Mailing Fax Number | 3143446179 |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2016-12-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 051287298 | IL | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 2006024046 | MO | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 606172302 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619238755 | Ryan William Russell | Pharmacist | 5574 Everglades St Ste A, Ventura, CA 93003-6542 | 2012-06-05 |
| 1154963114 | Ryan J Russell | Registered Nurse | 1509 Wilson Ter, Glendale, CA 91206-4007 | 2019-10-11 |
| 1841751187 | Ryan Russell | Student in an Organized Health Care Education/Training Program | 16 Bank St, Batavia, NY 14020-2250 | 2019-03-28 |
| 1740773019 | Ryan S Russell | Social Worker | 601 S Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2018-06-12 |
| 1366975906 | Ryan William Russell | Family Medicine | 3930 Northwoods Dr, Arden Hills, MN 55112-6963 | 2017-04-11 |
| 1669823647 | Ryan Russell | Pharmacist | 415 6th St, Lewiston, ID 83501-2431 | 2016-06-30 |
| 1265890669 | Ryan J Russell | Chiropractor | 406 E South Blvd, Crawfordsville, IN 47933-3762 | 2016-02-01 |
| 1063889848 | Ryan Nelson Russell | Chiropractor | 1580 Montgomery Hwy, Suite 14, Hoover, AL 35216-4586 | 2015-08-27 |
| 1689931602 | Ryan Cory Russell | Anesthesiology | 2401 S 31st St, Ms-20-d304, Temple, TX 76508-0001 | 2012-04-15 |
| 1710175559 | Ryan A Russell | Prosthetist | 8540 Reseda Blvd, Northridge, CA 91324-4628 | 2007-10-05 |
| Street Address |
12266 DE PAUL DR SUITE 105 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215994892 | Ardaman S. Nanda | Internal Medicine | 12266 De Paul Dr, 205, Bridgeton, MO 63044-2514 | 2006-04-27 |
| 1528477114 | Midwest Dental Sleep Medicine Institute,llc | Dentist | 12266 De Paul Dr, Suite 325, Bridgeton, MO 63044-2514 | 2014-08-07 |
| 1043514078 | Signature Health Services | Obstetrics & Gynecology | 12266 De Paul Dr, Suite 200, Bridgeton, MO 63044-2514 | 2011-01-05 |
| 1689978785 | Thomas Gotsis Dds PC | Durable Medical Equipment & Medical Supplies | 12266 De Paul Dr, #325, Bridgeton, MO 63044-2514 | 2011-01-04 |
| 1831282177 | Ardaman S Nanda Inc | Internal Medicine | 12266 De Paul Dr, 205, Bridgeton, MO 63044-2514 | 2006-09-30 |
| 1205940970 | Signature Health Services | Obstetrics & Gynecology | 12266 De Paul Dr, Suite 200, Bridgeton, MO 63044-2514 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053772491 | Moby Abraham | Pharmacist | 29 Cornwell Dr, Bridgeton, NJ 08302-3632 | 2016-03-13 |
| 1972843100 | Tracy Lynn Difilippantonio | Pharmacist | 393 Centerton Rd, Bridgeton, NJ 08302-5971 | 2013-02-25 |
| 1891051421 | Jessica Kent | Pharmacist | 12293 Saint Charles Rock Rd, Bridgeton, MO 63044-2502 | 2012-04-09 |
| 1609151661 | Linda Annobil | Pharmacist | 9 Landis Avenue, Bridgeton, NJ 08302 | 2011-10-20 |
| 1285953448 | Anna K Brecht | Pharmacist | 52 East Broad St, Bridgeton, NJ 08302 | 2010-05-26 |
| 1699092502 | Mark Difilippantonio | Pharmacist | 1070 N Pearl St, Bridgeton, NJ 08302-1215 | 2010-05-02 |
| 1497077200 | Douglas Alexander Laramie | Pharmacist | 11978 Saint Charles Rock Rd, Bridgeton, MO 63044-2636 | 2010-02-20 |
| 1447444039 | Emily Jean Reinke | Pharmacist | 12921 Enterprise Way, Bridgeton, MO 63044 | 2007-08-28 |
| 1902010820 | Richard K Mcmahan | Pharmacist | 12137 Bridgeton Sq, Bridgeton, MO 63044-2616 | 2007-05-09 |
| 1699861674 | Ssm Pharmacy @ Depaul | Pharmacist | 12255 De Paul Dr Ste 120, Bridgeton, MO 63044-2513 | 2006-10-05 |
| Find all providers in BRIDGETON | ||||
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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.