Renny Beau Russell, DC is a medicare enrolled "Chiropractor" provider in Pleasant Valley, Missouri. His current practice location is
6624 Royal St, Pleasant Valley, Missouri. You can reach out to his office (for appointments etc.) via phone at
(816) 824-9690.
Renny Beau Russell is licensed to practice in Missouri (license number 2008015663) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1003905456.
Healthcare Provider's Profile
| Full Name | Renny Beau Russell |
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| Gender | Male |
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| Speciality | Chiropractor |
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| Location | 6624 Royal St, Pleasant Valley, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1003905456
- Provider Enumeration Date: 10/12/2006
- Last Update Date: 04/16/2024
Medicare PECOS Information:
- PECOS PAC ID: 1456409085
- Enrollment ID: I20090508000028
Medical Identifiers
Medical identifiers for Renny Beau Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003905456 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | 3841 (Oklahoma) | Secondary |
| 111N00000X | Chiropractor | 2008015663 (Missouri) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Renny Beau Russell allows following entities to bill medicare on his behalf.
| Provider Name | Renny Russell Dc Pc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1609019587
PECOS PAC ID: 6800944430
Enrollment ID: O20090508000032 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Renny Beau Russell is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Renny Beau Russell, DC
8009 Ne 105th Ter,
Kansas City, MO 64157-9100
Ph: (816) 824-9690 | Renny Beau Russell, DC
6624 Royal St,
Pleasant Valley, MO 64068-8711
Ph: (816) 824-9690 |
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