Dale Joseph Russell, MS, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT1798 Issued in TX

Practice address

2820 Compton Rd
Wichita Falls, TX 76309-4931

Phone

(940) 733-5879

NPI assigned

Jan 3, 2020

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1043859358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 COMPTON RD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094931",
            "telephone_number": "940-733-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 COMPTON RD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094931",
            "telephone_number": "940-733-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DALE",
        "middle_name": "JOSEPH",
        "credential": "MS, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT1798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe B. Rupe, O.D.
• Brittany Jean Rushing, PHARMACIST
• Tyle Cash Rushing, PHARMACIST
• Emily Rusk, FNP-C
• Russell Kuempel MD LLC
• Teri Jo Russell, RD
• William Russell, D.O.
• Rebekah Nicole Russo, LVN
• David M. Sabine, PH.D.
• Sacred Space Counseling Center

• Athletic Trainer in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.