South Russell Family Practice, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTH RUSSELL FAMILY PRACTICE, INC.

Practice address

5192 Chillicothe Rd
Suite 101
Chagrin Falls, OH 44022-4196

Phone

(440) 338-3366

Fax

(440) 338-3332

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark N Rood, MD

Title

President

Phone

(440) 338-3366

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184732067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5192 CHILLICOTHE RD",
            "address_2": "SUITE 101",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440224196",
            "telephone_number": "440-338-3366",
            "fax_number": "440-338-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5192 CHILLICOTHE RD",
            "address_2": "SUITE 101",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440224196",
            "telephone_number": "440-338-3366",
            "fax_number": "440-338-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH RUSSELL FAMILY PRACTICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROOD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-338-3366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0591515",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank J Soltysiak Jr., DDS
• Charise Soreo, RN, CCM
• Michael Frederick Sosnoswsky
• Sami Lynn Sosnoswsky
• South Franklin Circle
• Stephanie Sprague, OTR/L
• St. Bonaventure Academy
• John Joseph St. John, D.C.
• Tina Kathleen St. John, D.C.
• Holly Eileen Stacho

• Family Medicine Physician in Chagrin Falls, OH
• Providers in Chagrin Falls, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.