Brett Lee Russell, PT,LMT,ATC

Primary specialty

SpecialistTaxonomy code 174400000X

License

2005 Issued in SC

Practice address

600 N Highway 25
Travelers Rest, SC 29690

Phone

(864) 834-4995

Fax

(864) 834-4551

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

Yes

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 SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brett Russell Physical Therapy and Fitness LLCGroup PAC ID 7012090673, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Brett Russell Physical Therapy and Fitness LLC

  • Physical Therapist
  • Travelers Rest, SC
  • NPI 1083704225
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1164512190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N HIGHWAY 25",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296909388",
            "telephone_number": "864-834-4995",
            "fax_number": "864-834-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HIGHWAY 25",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "29690",
            "telephone_number": "864-834-4995",
            "fax_number": "864-834-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BRETT",
        "middle_name": "LEE",
        "credential": "PT,LMT,ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "SC",
            "license": "2005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelynn Rodich, MS, RD
• William Lee Roehm, CRNA
• Brendan John Ross, DC
• Philip Rush, LMFT
• Paisley Staton Rushton, PHARMD
• Charity Robbin Salyers, DC
• Samaritan Bed & Bath Services Inc
• Rebecca Michelle Saul, N.P.
• Kelsey Kennedy Saunders, PA
• Haley Liang Schmidt

• Specialist in Travelers Rest, SC
• Providers in Travelers Rest, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.