Johanna Mercedez Russell, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11001221 Issued in FL

Practice address

425 N Lee St Ste 104
Jacksonville, FL 32204-1128

Phone

(904) 427-1250

NPI assigned

Dec 26, 2018

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Johanna Russell Professional name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cancer Specialists, LLC

  dba Cancer Specialists of North Florida

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1528323268

  Multi-Specialty

  Medicare reassignment NPD
• Shands Jacksonville Medical Center Inc

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1851892467

  Multi-Specialty

  Medicare reassignment NPD
• Cancer Specialists, LLC

  dba Florida Specialty Pharmacy

  • Pharmacy
  • Jacksonville, FL
  • NPI 1851656607
  NPD
• Shands Jacksonville Medical Center Inc

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1144962408
  NPD

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1205308640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N LEE ST STE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041128",
            "telephone_number": "904-427-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N LEE ST STE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041128",
            "telephone_number": "904-427-1250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Whitehall Dr",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865266",
            "country_code": "US",
            "telephone_number": "904-825-4500",
            "fax_number": "904-825-3672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOHANNA",
        "middle_name": "MERCEDEZ",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11001221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "RUSSELL",
            "credential": "APRN-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Charles Rayfield Russell III, MD
• Christen Michele Russell, O.D.
• Ella B Russell
• James Matthew Russell, M.D.
• Janis Kaye Russell, PHARMD, MBA
• Joshua Aaron Russell, DO
• Kaliyah Aretha Russell, CNA
• Lakisha Russell, LMT
• Lindsey Anne Russell, MD
• Madison Russell

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.