Tanya Russo, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0574 Issued in SC

Practice address

105 Yadkin St
Suite 303
Albemarle, NC 28001-3449

Phone

(803) 532-2208

NPI assigned

Oct 21, 2005

Sex

Female

Sole proprietor

No

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

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• McLeod Health Clarendon

  • Certified Registered Nurse Anesthetist
  • Manning, SC
  • NPI 1508218793
  Medicare reassignment NPD
• McLeod Health Clarendon

  • Rural Health Clinic/Center
  • Timmonsville, SC
  • NPI 1003461773
  NPD

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1013906098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601888",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601888",
            "telephone_number": "704-982-2683",
            "fax_number": "704-512-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 YADKIN ST",
            "address_2": "SUITE 303",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013449",
            "telephone_number": "803-532-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "TANYA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "0574",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2015-02335",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013906098",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roupas Sullivan Tremont PLLC-1
• Anthony M Rowell, COTA/L
• Molly Beth Russell-Dabbs
• Joanna Russell
• Teresa Payton Russell
• Safe at Home Care, LLC
• Albert L Salas, M.D.
• Leonard David Saltzman, MD
• Harold Sudhir Samuel, MD
• Kristy M Sanders, NCLDO, ABOC

• Pediatrics Physician in Albemarle, NC
• Providers in Albemarle, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.