DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.) – Sports Physician Chiropractor, NPI 1093714222

Sports Physician Chiropractor

DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.) is a healthcare provider. based in Traverse city, Michigan. specializing in CHIROPRACTIC. They hold the professional credentials D.C., C.C.S.P.. They hold a License No. KR007665 (MI). The NPI Number for DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.) is 1093714222

Main info

Male

Sole Proprietor

30 Years Of Experience

Accepts Medicare Assignment

Name

DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.)

NPI

1093714222

Phone

(231) 947-2228

Address

692 HANNAH AVE

Enumeration Date

19 July 2005

Deactivation Date

20 March 2006

Reactivation Date

24 March 2006

Last Update Date

9 September 2011

Doctor Profile

Medical School Name

NATIONAL COLLEGE OF CHIROPRACTIC

Secondary Phone

2319472228

Graduation Year

1996 (30 years ago)

PAC ID

4486724093

Group Practice PAC ID

1759451362

Professional Enrollment ID

I20080609000059

Address ID

MI496863110TR692XXAVEX302

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience54

Completeness75

Years active:20State licenses:1Digital endpointsOther names

1,869 CHIROPRACTIC in MI

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Provider Addresses for DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.)

692, Hannah Avenue, Traverse Heights, Traverse City, Grand Traverse County, Michigan, 49686, United States
SUITE A
TRAVERSE CITY, MI 496863110
Phone: (231) 947-2228
Fax: (231) 947-2616
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-06-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

Medicare enrolled
On CMS revalidation list
Due date assigned
Revalidate in PECOS

CMS enrollment records

Enrollment ID	Type	Specialty	State	Due date
I20080609000059	I	Chiropractic	MI	TBD

What to do next

No action required while the due date shows TBD.
Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCS	Description	Services	Beneficiaries	Medicare allowed
98941	Chiropractic manipulative treatment, 3-4 spinal regions	763	81	$0

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Insurance plans in this area (ZIP 49686)

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Provider's Procedures

DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.) performs procedures in CHIROPRACTIC. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
CHIROPRACTIC	MI	98940	Chiropractic manipulative treatment, 1-2 spinal regions	43	13

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 1759451362View full group profile

Name	Specialty	State
DR. EMILY ELAYNE JOHNSON (D.C.)	C H I R O P R A C T I C	MI
STACY RUHLAND (DC)	C H I R O P R A C T I C	IL

Reviews

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Frequently asked questions

What is the registry number for DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.)?

The registry entry for DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.) shows NPI 1093714222.

Does the public listing show DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.) as active?

DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.)'s NPI record reflects an active status in NPPES.

What services align with DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.)'s listing?

DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.)'s public classification highlights Sports Physician Chiropractor. Clinical services aligned with this taxonomy classification.

What city is tied to DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.)?

The directory associates DR. KERRY BRUCE RUSSELL (D.C., C.C.S.P.) with Traverse City, Michigan. Check all listed addresses for suites or satellite offices.

What is the difference between NPI and a medical license?

An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.