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Deactivated NPI 1598977597 Deactivated / Inactive NPI Male Practitioner

Dr. Russell Arthur Nickels , MD

General Practice • Smith River, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Russell Nickels has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 04, 2007
NPI Deactivation Date June 26, 2024
Total Practice Duration ~17 Years of Practice (2007 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Russell Nickels, MD was a registered General Practice practicing in Smith River, CA. Throughout an active medical career spanning 17 years, Dr. Nickels provided care at the practice location at 415 HIGHLAND AVE. until profile deactivation on 2024-06-26.

Practice Location & Contact Primary Location

Practice Address

415 Highland Ave.

Smith River, CA 95567

Telephone 7074872211
Fax 7074872211

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Smith River, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 31.1 Yrs
Regional Practice Density
2 Specialists

Practicing in Smith River, CA (2300 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License CA 00C306750

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Jody Mangum , LAC

Acupuncturist

NPI 1548387616

Licensed Acupuncturist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 26, 2024

Record deactivated on June 26, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 415 HIGHLAND AVE., SMITH RIVER, CA 95567 (Tel: 7074872211)

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Updated Business Mailing Address July 08, 2007

Registered at 415 HIGHLAND AVE., SMITH RIVER, CA 95567 (Tel: 7074872211)

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Provider Name / Credentials Updated July 08, 2007

Recorded as RUSSELL NICKELS, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

General Practice (License #00C306750 in CA)

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Initial NPI Registration & Enumeration May 04, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1598977597
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 04, 2007
Last Update: July 08, 2007
Deactivation Date: June 26, 2024

Mailing Address

415 Highland Ave.

Smith River, CA 95567

Phone: 7074872211

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.