Lisa A Russell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA0000003858 Issued in TN

Practice address

1204 Frye St
Athens, TN 37303

Phone

(423) 745-0434

NPI assigned

Nov 9, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225108046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 ARRANTS AVE",
            "city": "DECATUR",
            "state": "TN",
            "postal_code": "373227971",
            "telephone_number": "423-745-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 FRYE ST",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "37303",
            "telephone_number": "423-745-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "PTA0000003858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Rountree, FNP-BC
• Jessica Danielle Rouse
• Seth Rucker, PT
• Mandy Korinne Rush, COTA/L
• Dina Russell, PT
• David A. Rymer, D.C.
• Mallory Sanchez, SLP-CCC
• Tasneem Sandhu, DMD
• Amber Savage, BS
• Megan Savage

• Physical Therapy Assistant in Athens, TN
• Providers in Athens, TN by specialty
• Physical Therapy Assistant in Tennessee

• 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.