Active NPI
Holly L Russell, NP
- Nurse Practitioner
- Bedford, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71007594A
- Practice address
- 2900 16TH St
Bedford, IN 47421-3510 - Phone
- (812) 275-1200
- NPI assigned
- Oct 25, 2017
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71007594A | IN | Primary |
Addresses
Primary practice location
2900 16TH St
Bedford, IN 47421-3510
Mailing address
550 S Landmark Ave
Bloomington, IN 47403-3239
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171101003648 | IN | Practitioner - Nurse Practitioner | 2062778376 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iu Health Medical Group LLCIndiana University Health Southern Indiana Physicians LLC
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250
2900 16TH St
Bedford, IN 47421-3510
Phone (888) 484-3258
707 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258
719 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258
727 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258
Hospital & facility affiliations
- Indiana University Health Bloomington Hospital
- Indiana University Health Bedford Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71007594A | IN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Nurse Practitioner | Current | Accepting new patients |
| Indiana University Health Paoli Inc | Current | Accepting new patients | |
| Indiana University Health Paoli Inc | Current | Accepting new patients |
Locations
7992 Solution Ctr
Chicago, IL 60677
2900 16th St
Bedford, IN 47421
Phone (812) 275-1200
727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450
550 S Landmark Ave
Bloomington, IN 47403
Phone (812) 330-3688
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
642 W Hospital Rd
Paoli, IN 47454
Phone (812) 723-2811
560 W Longest St
Paoli, IN 47454
Phone (812) 723-7437
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
IN, Nurse Practitioner
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1013953983
IN
-
- Emergency Medical Services (Emergency Medicine) Physician
- Paoli, IN
- NPI 1457519324
IN
-
- Rural Health Clinic/Center
- Paoli, IN
- NPI 1679182190
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Bloomington, IN
- NPI 1205860335
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565654400000",
"number": "1104338623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 S LANDMARK AVE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474033239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 16TH ST",
"city": "BEDFORD",
"state": "IN",
"postal_code": "474213510",
"telephone_number": "812-275-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "HOLLY",
"middle_name": "L",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-25",
"last_updated": "2019-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71007594A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bedford, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.