Active NPI
Russell Poole, PT
- Physical Therapist
- Millersburg, PA
National Provider Identifier
1144219098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT002288L
- Practice address
- 75 Evelyn Dr
Millersburg, PA 17061-1258 - Phone
- (717) 692-4708
- Fax
- (717) 692-5464
- NPI assigned
- Oct 13, 2005
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT002288L | PA | Primary |
Addresses
Primary practice location
75 Evelyn Dr
Millersburg, PA 17061-1258
Mailing address
3425 N Carlisle St
2ND Floor, Hudson Building
Philadelphia, PA 19140-5108
Phone (215) 707-4739
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144219098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3425 N CARLISLE ST",
"address_2": "2ND FLOOR, HUDSON BUILDING",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405108",
"telephone_number": "215-707-4739",
"fax_number": "215-707-3677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 EVELYN DR",
"city": "MILLERSBURG",
"state": "PA",
"postal_code": "170611258",
"telephone_number": "717-692-4708",
"fax_number": "717-692-5464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POOLE",
"first_name": "RUSSELL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT002288L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Millersburg, PA
- Amanda L Peters, PT
- Erika L Peterson, DPT
- Pinnacle Health Medical Services (PinnacleHealth FamilyCare Millersburg)
- Pinnacle Health Medical Services (Pinnacle Health Family Care - Millersburg)
- Pinnacle Health Medical Services (Evelyn G Frederick Health Xrays)
- Ann Marie Potter, OTRL
- Premier at Susquehanna for Nursing and Rehabilitation LLC
- Stephanie K Rada, DPT
- Renal Care Group East, Inc. (Renal Care Group Millersburg)
- Stephanie Riddle, LSW
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.