Individual provider Active NPI

Christopher G Russell, LISW

  • Social Worker
  • Zanesville, OH
National Provider Identifier
1114086899
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I-0005374 Issued in OH
Practice address
975 Bethesda Dr
Zanesville, OH 43701-7500
Phone
(740) 452-4539
Fax
(740) 452-5702
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I-0005374 OH Primary

Addresses

Primary practice location

975 Bethesda Dr
Zanesville, OH 43701-7500

Mailing address

975 Bethesda Dr
Zanesville, OH 43701-7500
Phone (740) 452-4539

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-0005374OHMDSocial Worker
5374OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare of Southeastern Ohio, Inc. Past Accepting new patients
Ohio Psychiatric Associates, Inc Social Worker PastSince Feb 25, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114086899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 BETHESDA DR",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437017500",
            "telephone_number": "740-452-4539",
            "fax_number": "740-452-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 BETHESDA DR",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437017500",
            "telephone_number": "740-452-4539",
            "fax_number": "740-452-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "G",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I-0005374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.