Jessica Nicole Jack Russell, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1901879 Issued in OH

Practice address

425 Niles Cortland Rd SE
Warren, OH 44484-2478

Phone

(330) 856-3975

NPI assigned

Jan 17, 2007

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 OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Pittsburgh School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rajendra P Koirala, M.D., LLCGroup PAC ID 8820334931, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Rajendra P Koirala, M.D., LLC

  • Psychiatry Physician
  • Youngstown, OH
  • NPI 1760977177
  Medicare reassignment Care Compare group
• Rajendra P Koirala, M.D., LLC

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1265142830
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1184776692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4206 HOPKINS RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445113710",
            "telephone_number": "412-559-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 NILES CORTLAND RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842478",
            "telephone_number": "330-856-3975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Kensington Sq",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "New Kensington",
            "state": "PA",
            "postal_code": "150686443",
            "country_code": "US",
            "telephone_number": "724-335-9733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JESSICA",
        "middle_name": "NICOLE JACK",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara A Ruiter, CRNP
• Jessica Rullo
• Jason A Rupeka, DO
• Tyrese Rushton
• Billie Russell
• Reina Elizabeth Russell
• Jasmine Rutledge
• Andrew Francis Ryan, DPT
• Jamie Ryan
• Justin Ryan, MT

• Clinical Social Worker in Warren, OH
• Providers in Warren, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.
• 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.