Active NPI
Kathleen L Russell, PHARMD
- Pharmacist
- Chinle, AZ
National Provider Identifier
1174044572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S022267
- Practice address
- PO Box PH
Chinle, AZ 86503-8000 - Phone
- (928) 674-7414
- Fax
- (928) 674-7849
- NPI assigned
- Jul 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | S022267 | AZ | Primary |
Addresses
Primary practice location
PO Box PH
Chinle, AZ 86503-8000
Mailing address
PO Box PH
Chinle, AZ 86503-8000
Phone (928) 674-7414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S022267 | Other | AZ | PHARMACIST LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S022267 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499299200000",
"number": "1174044572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX PH",
"city": "CHINLE",
"state": "AZ",
"postal_code": "865038000",
"telephone_number": "928-674-7414",
"fax_number": "928-674-7849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX PH",
"city": "CHINLE",
"state": "AZ",
"postal_code": "865038000",
"telephone_number": "928-674-7414",
"fax_number": "928-674-7849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "KATHLEEN",
"middle_name": "L",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-06",
"last_updated": "2017-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S022267",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "S022267",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chinle, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.