Ashley Renee Russo

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1615 W Riverside Ave
Muncie, IN 47303

Phone

(765) 285-5178

Fax

(765) 285-8762

NPI assigned

Jul 13, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1093449282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3784 N TILLOTSON AVE APT 114",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041784",
            "telephone_number": "574-327-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 W RIVERSIDE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "47303",
            "telephone_number": "765-285-5178",
            "fax_number": "765-285-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "ASHLEY",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cole Daley Rudek
• Max H Rudicel, MD
• Alexandra Rufatto, SLP
• Dennis Brandon Runyon, NP
• Jessica Russell
• Anna Ryan
• Kasey Merritt Ryan, DDS, MSD
• Hannah Ryback, RBT
• Henry Sabijon, PT
• Sacred Spring Therapy, LLC

• Athletic Trainer in Muncie, IN
• Providers in Muncie, IN by specialty
• Athletic Trainer in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.