Sherri Carlyle Russell, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71005423A Issued in IN

Practice address

622 8TH Ave
Terre Haute, IN 47804-2744

Phone

(812) 231-8377

NPI assigned

Nov 20, 2014

Last updated

May 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

My Mobile MD Indiana LLCGroup PAC ID 9830607605, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• My Mobile MD Indiana LLC

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1912898321
  Medicare reassignment Care Compare group
• Hamilton Center, Inc.

  • Community/Behavioral Health Agency
  • Terre Haute, IN
  • NPI 1205980901
  Medicare reassignment NPD
• Truhealth, LLC

  • Nurse Practitioner
  • Parsons, TN
  • NPI 1063843951

  IN

  Medicare reassignment NPD
• SHC Medical Partners of Indiana, LLC

  • Nurse Practitioner
  • Carmel, IN
  • NPI 1407283781
  Medicare reassignment
• Carelon Medical Partners, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1124443403

  IN

  Medicare reassignment
• Hamilton Center Inc.

  dba Grace Clinic Health Professional

  • Federally Qualified Health Center (FQHC)
  • Terre Haute, IN
  • NPI 1205446259
  NPD
• Hamilton Center Inc.

  dba WIN Recovery-Knox

  • Methadone Clinic
  • Vincennes, IN
  • NPI 1265053854
  NPD

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1063819993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042771",
            "telephone_number": "812-231-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042744",
            "telephone_number": "812-231-8377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3834 S Emerson Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462035901",
            "country_code": "US",
            "telephone_number": "317-782-1577",
            "fax_number": "317-780-1577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SHERRI",
        "middle_name": "CARLYLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-20",
        "last_updated": "2021-05-07",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "28098686A",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71005423A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005423A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201285510",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000933823",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Rupska
• Michelle L Rupska
• Rush Memorial Hospital (Westminster Village Health & Rehab)
• Gary Dale Rusk, MD
• Russell Harms DPM PC
• Yvonne Denise Russell, PTA
• Nicholas Charles Rust, CRNA
• Rebecca Rust, BCBA
• Samuel Andrew Rusu, MD
• Brook Rutledge

• Family Nurse Practitioner in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.
• 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.