Jamie Russell

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT1245 Issued in MS

Practice address

206 Maryland Ave
McComb, MS 39648-3926

Phone

(601) 250-4815

NPI assigned

Apr 18, 2008

Last updated

Apr 18, 2008By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tri-Vista Rehab, Inc.Group PAC ID 0345390308, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tri-Vista Rehab, Inc

  • Physical Therapist
  • Tupelo, MS
  • NPI 1982799516

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Tri-Vista Rehab, Inc

  dba TriVista Rehab at Community Development Inc.

  • Rehabilitation Clinic/Center
  • Richton, MS
  • NPI 1265025522
  NPD

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1023282274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 LITTLE BLACK CREEK RD",
            "city": "LUMBERTON",
            "state": "MS",
            "postal_code": "394557881",
            "telephone_number": "601-520-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MARYLAND AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483926",
            "telephone_number": "601-250-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JAMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT1245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julian B Robinson Jr., RPH
• Julie A Ross, APRN, PMHNP, FNP-BC
• Rofunda Ross
• Nefraterri Rostick
• Lachanda Ruffin
• Vickie Russell
• Meera Sachdeva, MD
• Carlson Sama Babila, M.D.
• Sanders Eye Clinic
• Henry John Sanders IV, M.D.

• Occupational Therapist in McComb, MS
• Providers in McComb, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.