Jennifer Russell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1399 Issued in LA

Practice address

3341 Youree Dr Ste 20a
Shreveport, LA 71105-2149

Phone

(318) 425-2000

Fax

(318) 424-2601

NPI assigned

Apr 21, 2014

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

Enrolled in LA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Jennifer L Russell, Psychologist, LLC

  • Clinical Psychologist
  • Shreveport, LA
  • NPI 1316577141
  Medicare reassignment NPD
• Psychology Associates of N.W. Louisiana, L.L.C.

  • Forensic Psychologist
  • Shreveport, LA
  • NPI 1831739820

  Clinical

  Medicare reassignment NPD
• Ronald a Goebel & Mark P Vigen PTR

  • Clinical Psychologist
  • Shreveport, LA
  • NPI 1477732188
  Medicare reassignment NPD

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1114347846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3341 YOUREE DR STE 20A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052149",
            "telephone_number": "318-425-2000",
            "fax_number": "318-424-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3341 YOUREE DR STE 20A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052149",
            "telephone_number": "318-425-2000",
            "fax_number": "318-424-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JENNIFER",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "35083",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "1399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Johnson Rushing, PA-C
• Kendrise Rushing
• Paul A Rushing, MD
• Britni Russell, LPC
• Claude J Russell III
• Jessica Russell
• Kirsten McGee Russell, MCD, CCC-SLP
• Lawonda 71118 Russell
• Lekisha Russell, LPN
• Natalee Russell, PLPC

• Clinical Psychologist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Clinical Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.