NPIMap

Individual provider Active NPI

Byron Edward Russell, P.T.

  • Physical Therapist
  • Spokane, WA
National Provider Identifier
1114350576
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 00007695 Issued in WA
Practice address
310 North Riverpoint Blvd
Box V
Spokane, WA 99202-1675
Phone
(509) 828-1323
Fax
(509) 368-6890
NPI assigned
Aug 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 00007695 WA Primary

Addresses

Primary practice location

310 North Riverpoint Blvd
Box V
Spokane, WA 99202-1675

Mailing address

310 North Riverpoint Blvd
Box V
Spokane, WA 99202-1675
Phone (509) 828-1323

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
PT 00007695WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spokane Hearing-Oral Program of Excellence Past Accepting new patients
Eastern Washington University Hearing and Speech Past Accepting new patients

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": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1114350576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 NORTH RIVERPOINT BLVD",
            "address_2": "BOX V",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021675",
            "telephone_number": "509-828-1323",
            "fax_number": "509-368-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 NORTH RIVERPOINT BLVD",
            "address_2": "BOX V",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021675",
            "telephone_number": "509-828-1323",
            "fax_number": "509-368-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BYRON",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 00007695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.