Active NPI
Jan Renee Russell, PTA
- Physical Therapy Assistant
- Carlisle, PA
National Provider Identifier
1083672588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TE000975L
- Practice address
- 419 Village Dr
Ste 3
Carlisle, PA 17013 - Phone
- (717) 240-0330
- Fax
- (717) 240-0233
- NPI assigned
- May 3, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TE000975L | PA | Primary |
Addresses
Primary practice location
419 Village Dr
Ste 3
Carlisle, PA 17013
Mailing address
433 Arch Street
Carlisle, PA 17013
Phone (717) 243-2474
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TE000975L | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1083672588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "433 ARCH STREET",
"city": "CARLISLE",
"state": "PA",
"postal_code": "17013",
"telephone_number": "717-243-2474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 VILLAGE DR",
"address_2": "STE 3",
"city": "CARLISLE",
"state": "PA",
"postal_code": "17013",
"telephone_number": "717-240-0330",
"fax_number": "717-240-0233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "JAN",
"middle_name": "RENEE",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TE000975L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlisle, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.