Michelle Lynn Russell, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

800 Pennsylvania Avenue
Children's Medicine Center
Charleston, WV 25302

Phone

(304) 414-1880

Fax

(304) 414-1886

NPI assigned

Apr 18, 2023

Sex

Female

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 WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: michelle.russell.1@7363.direct.athenahealth.com

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1184310559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BEECHWOOD BLVD",
            "city": "PULASKI",
            "state": "PA",
            "postal_code": "161439302",
            "telephone_number": "724-714-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PENNSYLVANIA AVENUE",
            "address_2": "CHILDREN'S MEDICINE CENTER",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25302",
            "telephone_number": "304-414-1880",
            "fax_number": "304-414-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared T Russell
• John Benen Russell, PHARMD
• Joshua Russell
• Julia Russell
• Kimberly Dawn Russell
• Sara Kate Russell, RD
• Marnie Rustemeyer
• Charles Rutan
• Jessica Rutan
• Ashton Paige Rutherford, RN

• Student in an Organized Health Care Education/Training Program in Charleston, WV
• Providers in Charleston, WV by specialty
• Student in an Organized Health Care Education/Training Program in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.