Individual provider Active NPI

Jessica Ann Russell, CRNP- FAMILY

  • Family Nurse Practitioner
  • Conowingo, MD
National Provider Identifier
1114601689
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R196412 Issued in MD
Practice address
49 Rock Springs Rd
Conowingo, MD 21918-1352
Phone
(410) 378-9696
Fax
(410) 378-9922
NPI assigned
Jun 14, 2023
Last updated
May 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R196412 MD Primary

Addresses

Primary practice location

49 Rock Springs Rd
Conowingo, MD 21918-1352

Mailing address

PO Box 99
Conowingo, MD 21918-0099
Phone (410) 378-9696

Other names 1

  • Jessica Ann Russell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711000489 MD Practitioner - Nurse Practitioner 4880053776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
West Cecil Health Center Inc.Group PAC ID 6709964398, 20 clinicians

Practice addresses (Care Compare)

49 Rock Springs Rd
Conowingo, MD 21918-1352
Phone 41037896961130

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Cecil Health Center Inc. CurrentSince Jul 1, 2023 Accepting new patients
West Cecil Health Center Inc. Current Accepting new patients
West Cecil Health Center Inc. CurrentSince Jul 1, 2023 Accepting new patients
West Cecil Health Center Inc. Past Accepting new patients

Locations

49 Rock Springs Rd
Conowingo, MD 21918
Phone (877) 622-8484

253 Lewis Ln
Ste 202
Havre de Grace, MD 21078
Phone (443) 502-7060

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6703/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DAHIAD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1114601689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "CONOWINGO",
            "state": "MD",
            "postal_code": "219180099",
            "telephone_number": "410-378-9696",
            "fax_number": "410-378-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 ROCK SPRINGS RD",
            "city": "CONOWINGO",
            "state": "MD",
            "postal_code": "219181352",
            "telephone_number": "410-378-9696",
            "fax_number": "410-378-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "CRNP- FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R196412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "RUSSELL",
            "middle_name": "ANN",
            "credential": "CRNP-FAMILY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conowingo, MD

Sources for this page

Verify at the official NPI Registry.