Tanya Russell, FNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP122632 Issued in TX

Practice address

4515 Marsha Sharp Fwy
Lubbock, TX 79407

Phone

(806) 744-7223

Fax

(806) 740-3325

NPI assigned

Feb 6, 2014

Last updated

Mar 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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.

• Grace Clinic of Lubbock

  dba Grace Clinic

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1912953357
  Medicare reassignment NPD
• Grace Clinic of Lubbock

  dba Expresscare Virtual

  • Multi-Specialty Clinic/Center
  • Lubbock, TX
  • NPI 1770237042
  NPD
• Texas Tech University Health Sciences Center University Associates

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1902832181
  NPD (past)

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1225452600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79407",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2424 50th St",
            "address_2": "STE 202",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794122549",
            "country_code": "US",
            "telephone_number": "806-776-0891",
            "fax_number": "806-776-0899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "TANYA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-06",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "735250",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP122632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trussell1405179@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4515 Marsha Sharp Fwy",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794072520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rushland Park Surgicenter, LP
• Vivian Pham Duong Rushton, PHARMD
• Cie Russell
• Elizabeth M Russell, LMT
• Mark Dale Russell, D.C.
• Emily Ruth
• Kimberly Ruthardt
• Allison Ruthart, SLP
• Dee Wayne Rutherford, LAT
• Doungporn Ruthirago, M.D.

• Pediatric Nurse Practitioner in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.