Russell Carroll Allen Jr., PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6934 Issued in ME

Practice address

690 Minot Ave Ste 2
Auburn, ME 04210-3922

Phone

(207) 753-3456

Fax

(207) 782-9000

NPI assigned

Aug 20, 2024

Last updated

Aug 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater Brunswick Physical Therapy PAGroup PAC ID 8426019621, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

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.

• Greater Brunswick Physical Therapy P.a.

  dba Lewiston-Auburn Physical Therapy

  • Physical Therapist
  • Topsham, ME
  • NPI 1568567659
  Medicare reassignment Care Compare group NPD
• Central Maine Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1689653487
  Medicare reassignment NPD
• Central Maine Medical Center

  dba CMMC Specialty Pharmacy

  • Community/Retail Pharmacy
  • Lewiston, ME
  • NPI 1033874458
  NPD
• Central Maine Medical Center

  dba Manchester Care Center

  • Multi-Specialty Clinic/Center
  • Manchester, ME
  • NPI 1598411175
  NPD

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724544000000",
    "number": "1124851803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 FLETCHER RD",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108874",
            "telephone_number": "207-577-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MINOT AVE STE 2",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103922",
            "telephone_number": "207-753-3456",
            "fax_number": "207-782-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "RUSSELL",
        "middle_name": "CARROLL",
        "name_suffix": "Jr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-25",
        "certification_date": "2024-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT6934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agnes McNally LCPC
• Abdifatah H Ahmed, PHARM D.
• Mohamed Ali Al Saied, MD, CCFP, FRCS(C)
• Shirley L. Ala, PA-C
• Jennifer L. Alexander, LCSW, LADC
• Alvino Counseling, PLLC
• Amanda Ettinger Nutrition LLC
• Katherine Marie Amsden, LCSW, CP
• Anastasia Theodorou D.M.D. , P.a. (Great Falls Dental Associates)
• Androscoggin Cardiology Associates

• Physical Therapist in Auburn, ME
• Providers in Auburn, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.