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DR. KERRY BRUCE RUSSELL D.C., C.C.S.P.
NPI 1093714222
Chiropractor - Sports Physician in Traverse City, MI

Active since July 19, 2005Accepts Medicare Assignment
692 HANNAH AVE, SUITE A, TRAVERSE CITY, MI 49686(231) 947-2228(231) 947-2616 Get Directions Write a Review

NPPES record last updated: September 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kerry Bruce Russell D.c., C.c.s.p. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KERRY BRUCE RUSSELL D.C., C.C.S.P. (NPI 1093714222) is an individual sports physician in Traverse City, Michigan, licensed in Michigan (KR007665) and active in the NPI registry since July 2005. He is a graduate of National College Of Chiropractic (1996).

NPPES Registry Identity

NPI1093714222
Entity TypeIndividualMale
Primary Taxonomy111NS0005X
Provider Legal NameDR. KERRY BRUCE RUSSELLCredential: D.C., C.C.S.P.
Location Address692 HANNAH AVE, SUITE ATraverse City, MI 49686-3110
Mailing Address692 Hannah Ave, Suite ATraverse City, MI 49686-3110 · (231) 947-2228 · Fax (231) 947-2616
Phone(231) 947-2228
Fax(231) 947-2616
Sole ProprietorYes
Medical School CMSNational College Of ChiropracticGraduated 1996
Enumeration DateJuly 19, 2005
Last NPPES UpdateSeptember 9, 2011
✔ NPI 1093714222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractor · Sports PhysicianChiropractic Providers
Taxonomy Code111NS0005X
License✔ Licensed in MI · KR007665
Definition
A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.
692 HANNAH AVE, Traverse City, MI 49686
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Other Identifiers 8

Medicare ID-Type UnspecifiedON50110MI
Other611406599MI · Ppom
OtherU72489MI · Priority Health
OtherP99464MI · Blue Care Network
Other950B850440MI · Bcbsm Ppo
Other15934MI · Mcare
Medicare UPINU72489MI
Medicaid4417133MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kerry Bruce Russell D.c., C.c.s.p. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486724093
PECOS Enrollment IDI20080609000059

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 3-4 spinal regions 98941
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
844 services70 patients

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EMILY ELAYNE JOHNSON D.C.
Chiropractor
692 HANNAH AVE, SUITE A
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-2228
NATURAL ADVANTAGE CHIROPRACTIC, PLLC
Chiropractor
692 HANNAH AVE, SUITE A
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-2228

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kerry Russell's NPI number?

The NPI number for Kerry Russell is 1093714222. It was assigned to this individual provider in the NPPES registry on July 19, 2005.

Where is Kerry Russell located?

Kerry Russell practices at 692 Hannah Ave Suite A, Traverse City, MI 49686. The listed phone number is (231) 947-2228.

What is Kerry Russell's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Is Kerry Russell enrolled in Medicare?

Yes. Kerry Russell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kerry Russell accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Kerry Russell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kerry Russell was last updated on September 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.