Amorette D Russell, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2003025349 Issued in MO

Practice address

625 S New Ballas Rd
Suite R-7040
Saint Louis, MO 63141-8232

Phone

(314) 251-6970

Fax

(314) 251-1053

NPI assigned

Feb 3, 2006

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)

Enrolled

Credentials

Physician Assistant

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.

• Mercy Clinic Cardiovascular and Thoracic Surgery, LLC

  • Vascular Surgery Physician
  • Washington, MO
  • NPI 1528192416
  NPD (past)

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225000102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S NEW BALLAS RD",
            "address_2": "SUITE R-7040",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6970",
            "fax_number": "314-251-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S NEW BALLAS RD",
            "address_2": "SUITE R-7040",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6970",
            "fax_number": "314-251-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "AMORETTE",
        "middle_name": "D",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2003025349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Russell Ricci, LCSW
• Jo Russell-Brown, M.ED.
• Duana C Russell-Thomas, OT
• Aaron Jacob Russell, MD
• Amanda Rae Russell
• Audrey A Russell, DC
• Becky Lee Russell, OT
• Blake Russell
• Bridget Rena Russell, RN, BS
• Collin Russell, MD

• Surgical Physician Assistant in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Surgical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.