Michelle Renee Russell, P.T.A

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TE002061L Issued in PA

Practice address

900 Tuck St
Lebanon, PA 17042-7446

Phone

(717) 273-8595

NPI assigned

Sep 30, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1205086949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 REDWOOD LN",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170462039",
            "telephone_number": "717-279-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TUCK ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427446",
            "telephone_number": "717-273-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "P.T.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE002061L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette E. Royer, MHS., NCGC
• Timothy Rudowsky, PA-C
• Rachel Ruetiman, CRNP
• Yvette Irene Ruiz, M.ED.,LPC
• Michael Rusli, MD
• Cassandra Rutledge, LCSW
• Allyson Ruvolo
• Gayle Blanchard Ryan, MD
• S & S Medical Transport LLC
• S&T Home Care LLC

• Physical Therapy Assistant in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.