Active NPI
Jay C Russell, RPH
- Pharmacist
- Wadsworth, OH
National Provider Identifier
1205825478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03-3-09809
- Practice address
- 175 Great Oaks TRL
Wadsworth, OH 44281-8712 - Phone
- (330) 336-3588
- Fax
- (330) 336-5479
- NPI assigned
- Oct 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03-3-09809 | OH | Primary |
Addresses
Primary practice location
175 Great Oaks TRL
Wadsworth, OH 44281-8712
Mailing address
3747 Poe Rd
Medina, OH 44256-9791
Phone (330) 722-3713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1205825478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3747 POE RD",
"city": "MEDINA",
"state": "OH",
"postal_code": "442569791",
"telephone_number": "330-722-3713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 GREAT OAKS TRL",
"city": "WADSWORTH",
"state": "OH",
"postal_code": "442818712",
"telephone_number": "330-336-3588",
"fax_number": "330-336-5479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "JAY",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-19",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03-3-09809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wadsworth, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.