Active NPI
Elizabeth Russell
- Occupational Therapy Assistant
- Jonesboro, AR
National Provider Identifier
1013724715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- Practice address
- 151 Southwest Dr
Jonesboro, AR 72401-5828 - Phone
- (870) 932-0090
- Fax
- (870) 930-9336
- NPI assigned
- Dec 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | Primary |
Addresses
Primary practice location
151 Southwest Dr
Jonesboro, AR 72401-5828
Mailing address
4212 Aggie Rd Apt 12
Jonesboro, AR 72405-8523
Phone (573) 429-0815
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734307200000",
"number": "1013724715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4212 AGGIE RD APT 12",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724058523",
"telephone_number": "573-429-0815",
"fax_number": "870-930-9336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 SOUTHWEST DR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724015828",
"telephone_number": "870-932-0090",
"fax_number": "870-930-9336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-16",
"last_updated": "2024-12-16",
"certification_date": "2024-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.