Active NPI
Tess Russell, OD
- Optometrist
- Toledo, OH
National Provider Identifier
1013601186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT.007174
- Practice address
- 5203 Monroe St
Toledo, OH 43623-3139 - Phone
- (567) 455-9232
- NPI assigned
- Jun 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT.007174 | OH | Primary |
Addresses
Primary practice location
5203 Monroe St
Toledo, OH 43623-3139
Mailing address
510 Highland Ave # 345
Milford, MI 48381-1516
Phone (810) 404-2962
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT.007174 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685664000000",
"number": "1013601186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 HIGHLAND AVE # 345",
"city": "MILFORD",
"state": "MI",
"postal_code": "483811516",
"telephone_number": "810-404-2962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5203 MONROE ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436233139",
"telephone_number": "567-455-9232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "TESS",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-02",
"last_updated": "2023-06-02",
"certification_date": "2023-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OH",
"license": "OPT.007174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.