DR. ROBERT LARON RUSSELL (NPI# 1407052376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407052376 |
| Entity Type | Individual |
| Full Name | DR. ROBERT LARON RUSSELL |
| Credential | MD |
| Practice Address |
3920 St Francis Way Ste 209 Lafayette IN 47905 |
| Mailing Address |
1040 Sierra Dr Ste 400 Greenwood IN 46143-7241 |
| Practice Telephone | 7657752830 |
| Mailing Telephone | 3175284800 |
| Mailing Fax Number | 3178651479 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2019-01-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 2006034008 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201214540 | 05 | |
| ANTHEM | 000001161691 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1051 Cumberland Ave, West Lafayette, IN 479061447 | 7654232571 | |
| 1205 N 14th St, Lafayette, IN 479042024 | 7654234861 | |
| 1700 Lindberg Rd, West Lafayette, IN 479067317 | 7654645600 | |
| 1701 S Creasy Ln, Lafayette, IN 479054972 | 7655024400 | |
| 1750 S Creasy Ln, Lafayette, IN 479054911 | 7654476600 | |
| 2201 Cason St, Lafayette, IN 479042613 | 7654474102 | |
| 2402 South St, Lafayette, IN 479043063 | 7654469229 | |
| 2741 N Salisbury St, West Lafayette, IN 479061431 | 7654637546 | |
| 502 W Jackson St, Mulberry, IN 460589538 | 7652962911 | |
| 741 Park East Blvd, Lafayette, IN 479050797 | 7654463540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932694791 | Robert Edward Russell II | Counselor | 1590 Coal Run Rd., Zanesville, OH 43701 | 2018-06-25 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1861813628 | Robert Russell | Psychologist | 1009 Woodlawn Park Dr, Flint, MI 48503-2762 | 2013-12-21 |
| 1861674806 | Robert Claude Russell | Internal Medicine | 802 Killion St, Louisville, TN 37777-4407 | 2007-12-01 |
| 1356538151 | Robert Ross Russell | Dentist | 2402 Loganville Hwy, Suite 500, Grayson, GA 30017-1689 | 2007-09-26 |
| 1912046533 | Robert Mark Russell | Preventive Medicine | 11210 E Calle Linda Vis, Tucson, AZ 85748-7839 | 2007-02-06 |
| 1477600328 | Robert Thomason Russell | Surgery | 1600 7th Ave S # Acc300, Birmingham, AL 35233-1711 | 2007-01-04 |
| 1528151610 | Robert L Russell | Family Medicine | 305 Highway 51, Ridgeland, MS 39157-3428 | 2006-10-02 |
| 1104850684 | Robert Alan Russell | Chiropractor | 25 East Broad Street, Mount Vernon, NY 10552 | 2006-07-10 |
| 1700823879 | Robert C Russell | Plastic Surgery | 320 E Carpenter St, Springfield, IL 62702-5185 | 2006-05-31 |
| Street Address |
3920 ST FRANCIS WAY STE 209 |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538292230 | Kimberly K Jefvert | Nurse Practitioner | 3920 St Francis Way Ste 209, Lafayette, IN 47905-4917 | 2007-03-13 |
| 1104479013 | Kelsey Rader | Nurse Practitioner | 3920 St Francis Way Ste 209, Lafayette, IN 47905-4917 | 2019-07-19 |
| 1902317282 | Crystal Leah Davit | Nurse Practitioner | 3920 St Francis Way Ste 209, Lafayette, IN 47905-4917 | 2017-10-13 |
| 1083135909 | Lingxiao Lu | Nurse Practitioner | 3920 St Francis Way Ste 209, Lafayette, IN 47905-4917 | 2017-06-30 |
| 1518487677 | Wauntesha Hardy | Nurse Practitioner | 3920 St Francis Way Ste 209, Lafayette, IN 47905-4917 | 2017-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144501 | Sw Louisiana Internal Medicine LLC | Internal Medicine | 105 Patriot St Ste 202, Lafayette, LA 70508-6831 | 2020-11-04 |
| 1205340676 | Robert Caspari | Internal Medicine | 2465 Cana Ct, Lafayette, CO 80026-9345 | 2017-11-21 |
| 1285151282 | Internal Medicine Clinic of Acadiana, LLC | Internal Medicine | 100 Waterford Dr, Lafayette, LA 70503-5401 | 2017-08-29 |
| 1669823142 | Lafayette Weight Loss Clinic, LLC | Internal Medicine | 5439 Johnston St, Lafayette, LA 70503-5135 | 2016-06-27 |
| 1689024911 | Himani Reddy Manthena | Internal Medicine | 401 Youngsville Hwy Ste 200b, Lafayette, LA 70508-5173 | 2016-06-17 |
| 1295196194 | Emily Charlie | Internal Medicine | 155 Hospital Dr Ste 205, Lafayette, LA 70503-2852 | 2016-03-19 |
| 1285095372 | Chad N Heinen Md Hospitalist Corporation | Internal Medicine | 310 Highway 89, Lafayette, LA 70508-4524 | 2016-03-16 |
| 1316308190 | Linda Lipstate | Internal Medicine | 408 Roswell Xing, Lafayette, LA 70508-6778 | 2016-03-08 |
| 1821484833 | Shantell Ceaser | Internal Medicine | 2390 West Congress Street., Lafayette, LA 70506 | 2015-04-07 |
| 1932511821 | Rory Bennett | Internal Medicine | 515 Saint Julien Ave, Lafayette, LA 70506-4735 | 2014-05-27 |
| Find all providers in LAFAYETTE | ||||
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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.