DR. KIMBERLY TANIS RUSSELL (NPI# 1720130305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720130305 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY TANIS RUSSELL |
| Credential | MD |
| Practice Address |
3404 Kaydence Ct Killeen TX 76542-3338 |
| Practice Telephone | 2545336017 |
| Practice Fax Number | 2546803655 |
| Mailing Telephone | 2545536017 |
| Mailing Fax Number | 2546803655 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2016-10-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | N0422 | TX | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MD069021L | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902085566 | Kimberly Kd Russell | Occupational Therapist | 1812 N Spualding Ave, Chicago, IL 60647 | 2007-10-31 |
| 1225227648 | Kimberly Russell | Obstetrics & Gynecology | 7545 Beechmont Ave Ste B, Cincinnati, OH 45255 | 2007-10-22 |
| 1003939943 | Kimberly Ann Russell | Social Worker | 617 Ne Davis St, Mcminnville, OR 97128-4716 | 2007-04-07 |
| 1992718837 | Kimberly J Russell | Physical Therapist | 135 S Barrington Pl, Los Angeles, CA 90049-3305 | 2006-08-14 |
| 1699710632 | Kimberly A Russell | Nurse Anesthetist, Certified Registered | 7813 Via Verde Dr, Austin, TX 78739-1980 | 2006-06-16 |
| 1902443245 | Kimberly Ann Russell | Behavioral Analyst | 88 Inverness Cir E Ste 104, Englewood, CO 80112-5304 | 2019-12-05 |
| 1649746025 | Kimberly Lynn Russell | Physician Assistant | 9221 University Blvd Ste 102, North Charleston, SC 29406-9148 | 2018-10-23 |
| 1629552906 | Kimberly Russell | Counselor | 1255 Kendall Rd, San Luis Obispo, CA 93401-8750 | 2018-09-21 |
| 1205373693 | Kimberly Russell | Social Worker | 7826 Eastern Ave Nw, Suite 201, Washington, DC 20012-1324 | 2017-01-24 |
| 1457894297 | Kimberly Russell | Counselor | 751 Bayou Pines East Dr Ste C, Lake Charles, LA 70601-7196 | 2016-11-28 |
| Street Address |
3404 KAYDENCE CT |
| City | KILLEEN |
| State | TX |
| Zip Code | 76542-3338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144614215 | Denise Michelle Douglas | Physician Assistant | 3404 Kaydence Ct, Killeen, TX 76542 | 2015-03-26 |
| 1821419524 | Carl R Darnall Army Medical Center | Clinic/Center | 3404 Kaydence Ct, Killeen, TX 76542 | 2013-12-23 |
| 1295035673 | Carl R Darnall Army Medical Center | Military/U.S. Coast Guard Pharmacy | 3404 Kaydence Ct, Killeen, TX 76542-3338 | 2010-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841839446 | Phuong Lan Carter | Counselor | 9312 Bowlfield Drive, Killeen, TX 76542 | 2019-12-30 |
| 1083252209 | Killeen Dental and Orthodontics Pllc | Dentist | 2620 Trimmier Rd, Killeen, TX 76542 | 2019-12-18 |
| 1750935391 | Leo Mora Therapy Services Pllc | Marriage & Family Therapist | 400 W. Jasper Dr. Ste. 100b, Killeen, TX 76542 | 2019-08-01 |
| 1730742305 | Angela Eads | Behavioral Analyst | 3106 S Ws Young Dr, Building A, Suite 104/105, Killen, TX 76542 | 2019-04-18 |
| 1801370572 | Keri Keller | Dentist | 507 W Stan Schlueter Loop Ste 400, Killeen, TX 76542 | 2018-09-19 |
| 1740787209 | Cynthia Waller | Speech-Language Pathologist | 4205 Old Florence Road, Killeen, TX 76542 | 2018-04-11 |
| 1275034597 | Killeen Modern Dentistry, PC | Dentist | 507 W Stan Schlueter Loop, Suite 104, Killeen, TX 76542 | 2018-02-22 |
| 1780182691 | Jennifer Monique Coleman | Counselor | 9706 Shimla Drive, Killeen, TX 76542 | 2018-01-25 |
| 1255870440 | Glori Sommerer | Counselor | 100 S Central Texas Expressway, # 208, Harker Heights, TX 76542 | 2017-02-21 |
| 1306382775 | Dana Michelle Kerekes | Massage Therapist | 5001 Teal Drive, Killeen, TX 76542 | 2017-01-10 |
| Find all providers in zip 76542 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164056750 | Smb Healthcare Services | Family Medicine | 3604 S W S Young Dr Apt 328, Killeen, TX 76542-2943 | 2020-02-24 |
| 1790329381 | Yemisi Docas Abudu | Family Medicine | 400 W Orion Dr, Killeen, TX 76542-0007 | 2019-11-06 |
| 1386811198 | Jay Mckenna | Family Medicine | 3202 S W S Young Dr Ste 106, Killeen, TX 76542-6537 | 2008-05-12 |
| 1417160417 | Jeremy Lloyd Swain | Family Medicine | 3800 S W S Young Dr Ste 402, Killeen, TX 76542-3374 | 2007-05-07 |
| 1023169448 | Ronald Gelzer | Family Medicine | 2900 Trimmier Rd, Killeen, TX 76542-6005 | 2007-01-13 |
| 1588736870 | Killeen Medical Clinic, P.a. | Family Medicine | 502 W Jasper Dr, Killeen, TX 76542-1312 | 2006-11-14 |
| 1619060712 | Stillhouse Emergency Physicians | Family Medicine | 3816 S Clear Creek, Suite D, Killeen, TX 76549-4400 | 2006-10-02 |
| 1992808018 | Dave E Webster | Family Medicine | 5610 E Central Texas Expy Ste 1, Killeen, TX 76543-5600 | 2006-09-06 |
| 1376564153 | Arturo Guajardo | Family Medicine | 3800 S Ws Young, Suite 103, Killeen, TX 76542-3312 | 2006-07-21 |
| 1275598187 | Cesar Emilio Cantu | Family Medicine | 5702 E Central Texas Expy, Killeen, TX 76543-5500 | 2006-04-20 |
| Find all providers in KILLEEN | ||||
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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.