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Deactivated NPI 1558366781 Deactivated / Inactive NPI Male Practitioner

Dr. Bryan C Russell , DC

Chiropractor • Marlton, NJ

✓ Accepts Medicare Assignment
⚠️

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. Bryan Russell has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 15, 2005
NPI Deactivation Date March 17, 2006
Total Practice Duration ~10 Years of Practice (1996 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Bryan Russell, DC was a registered Chiropractor in Marlton, NJ. Prior to record deactivation on 2006-03-17, Dr. Russell completed approximately 10 years of clinical practice following graduation from Life Chiropractic College in 1996.

Dr. Russell accepted Medicare assignment.

Historical Medicare Part B clinical services included chiropractic manipulative treatment, 3-4 spinal regions. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

651 Route 73 N Ste 304

Marlton, NJ 080533446

Telephone 8569834499
Fax 8569830435
Associated Practice Facility / Clinic
🏢 Bryan C Russell Facility NPI 1336193119

Medicare Profile & Education

Medical School

Life Chiropractic College

Graduation Year

1996

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Marlton, NJ

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
30 Yrs +2.8 yrs vs City Avg
City Avg: 27.2 Yrs
State Avg: 29.0 Yrs
Regional Practice Density
25 Specialists

Practicing in Marlton, NJ (3049 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
17.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Russell (30 Years) 30 Yrs
Marlton Specialty Average (27.2 Years) 27.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
98941 Chiropractic manipulative treatment, 3-4 spinal regions
1,111 88 $50.00 $41.20

Medical Specialties & State Licenses

CMS Verified: 2023-12-28
Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License NJ MC04977

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Multiplan
5716020 (NJ)
Commercial Insurance / Payer ID United Healthcare
1874679 (NJ)
Commercial Insurance / Payer ID Aetna
5257680 (NJ)
Commercial Insurance / Payer ID Acn
662068 (NJ)
Commercial Insurance / Payer ID Amerihealth
0741915000 (NJ)
Commercial Insurance / Payer ID Oxford
P2039337 (NJ)

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location December 28, 2023

Registered at 651 ROUTE 73 N STE 304, MARLTON, NJ 080533446 (Tel: 8569834499)

📍
Updated Business Mailing Address December 28, 2023

Registered at 651 ROUTE 73 N STE 304, MARLTON, NJ 080533446 (Tel: 8569834499)

📍
Updated Practice Location December 08, 2011

Registered at 12000 LINCOLN DR W, SUITE 304, MARLTON, NJ 080533402 (Tel: 8569834499)

📍
Updated Business Mailing Address December 08, 2011

Registered at 12000 LINCOLN DR W, SUITE 304, MARLTON, NJ 080533402 (Tel: 8569834499)

👤
Provider Name / Credentials Updated December 08, 2011

Recorded as BRYAN RUSSELL, DC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 08, 2011

Chiropractor (License #MC04977 in NJ)

🔄
NPI Profile Reactivated April 07, 2006

Record officially reactivated for active practice on April 07, 2006

⚠️
NPI Profile Deactivated March 17, 2006

Record deactivated on March 17, 2006

🟢
Initial NPI Registration & Enumeration June 15, 2005

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: 1558366781
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 15, 2005
Last Update: December 28, 2023
Deactivation Date: March 17, 2006
Sole Proprietor: Yes

Mailing Address

651 Route 73 N Ste 304

Marlton, NJ 080533446

Phone: 8569834499

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.