Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1881809242 Deactivated / Inactive NPI Male Practitioner

Dr. Larry E J Russell , DC

Chiropractor • Beaver Dam, WI

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

Registration / Start Date May 11, 2007
NPI Deactivation Date February 18, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Larry Russell, DC was a registered Chiropractor practicing in Beaver Dam, WI. Throughout an active medical career spanning 15 years, Dr. Russell provided care at the practice location at 604 SCOTT ST until profile deactivation on 2022-02-18.

Practice Location & Contact Primary Location

Practice Address

604 Scott St

Beaver Dam, WI 539161024

Telephone 9208877156
Fax 9208877290
Associated Practice Facility / Clinic
🏢 Lentscher Brothers Llc Facility NPI 1932190311

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Beaver Dam, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.3 Yrs
State Avg: 22.4 Yrs
Regional Practice Density
11 Specialists

Practicing in Beaver Dam, WI (2664 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

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License WI 1286012

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.

Practice Associates & Co-Workers

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

5 Associated Practitioners
NPI 1033100193

Doctor of Chiropractic

Dr. Morgan Nelson , DPT

Physical Therapist

NPI 1184350894

Doctor of Physical Therapy

Joshua Lentscher

Chiropractor

NPI 1316338015
NPI 1427634310

Doctor of Chiropractic

NPI 1518268440

Doctor of Chiropractic

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 February 18, 2022

Record deactivated on February 18, 2022

NPI Profile Active July 30, 2009

NPI status registered as active in NPPES database

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Updated Practice Location July 30, 2009

Registered at 604 SCOTT ST, BEAVER DAM, WI 539161024 (Tel: 9208877156)

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Updated Business Mailing Address July 30, 2009

Registered at 250 CORPORATE DR, BEAVER DAM, WI 53916 (Tel: 9208877156)

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Provider Name / Credentials Updated July 30, 2009

Recorded as LARRY RUSSELL, DC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 30, 2009

Chiropractor (License #1286012 in WI)

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Initial NPI Registration & Enumeration May 11, 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: 1881809242
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 11, 2007
Last Update: July 30, 2009
Deactivation Date: February 18, 2022

Mailing Address

250 Corporate Dr

Beaver Dam, WI 53916

Phone: 9208877156

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.