Kimberly Ann Russell, B.S

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

617 NE Davis St
McMinnville, OR 97128-4716

Phone

(503) 472-4020

NPI assigned

Apr 7, 2007

Last updated

Dec 3, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1003939943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 WESTBROOK DR NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973042955",
            "telephone_number": "503-510-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 NE DAVIS ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284716",
            "telephone_number": "503-472-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "B.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50067381",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Dawn Ruiz
• Benjamin Rulla
• Belinda Russell, CRM
• Deanna Nicole Russell, M.S.
• Jared Russell, PTA
• Jeffrey Robert Russo, D.P.M.
• Matthew Rutherford, CRM, PSS, THW
• Kathrina Rutschman
• Batoul Saad, PHARM.D.
• Jamie Sabins

• Case Manager/Care Coordinator in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Case Manager/Care Coordinator in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.