Ryan Russell, MSSLP.CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP #2073 Issued in AR

Practice address

6701 Highway 67
Benton, AR 72015-8909

Phone

(501) 860-0777

NPI assigned

Mar 20, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003931577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 CHARLSEA LN",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152390",
            "telephone_number": "501-860-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 HIGHWAY 67",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720158909",
            "telephone_number": "501-860-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "RYAN",
        "credential": "MSSLP.CCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP #2073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Rudkin, RECOVERY ASSISTANT
• Ava Rumph
• Christopher Runnells
• Elizabeth Diane Russell, PT
• Malarie Elife Russell, BCBA
• Seth Russell, CMP
• Venemany Russell, MS CCC SLP
• Dale Edward Ryan
• Tonya Sacomani
• Salco NC 2, Inc.

• Speech-Language Pathologist in Benton, AR
• Providers in Benton, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.