Individual provider Active NPI

Erica Ashley Russell

  • Speech-Language Pathologist
  • Dover, DE
National Provider Identifier
1235543109
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
O1-0001580 Issued in DE
Practice address
1080 Silver Lake Blvd
Dover, DE 19904-2410
Phone
(410) 312-7631
Fax
(410) 510-1779
NPI assigned
Jun 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 07558 MD
Speech-Language Pathologist 235Z00000X O1-0001580 DE Primary

Addresses

Primary practice location

1080 Silver Lake Blvd
Dover, DE 19904-2410

Mailing address

1080 Silver Lake Blvd
Dover, DE 19904-2410
Phone (410) 312-7631

Other practice location 1

1111 E Cold Spring Ln
Rehab Department
Baltimore, MD 21239-3932
Phone (410) 323-0500 ext. 347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140804001684 MD Practitioner - Qualified Speech Language Pathologist 3678790300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Hospital of Cecil CountyGroup PAC ID 6901719822, 281 clinicians

Practice addresses (Care Compare)

106 Bow St
Elkton, MD 21921-5544
Phone (410) 398-4000

111 W High St
Elkton, MD 21921-5549

Merit-based Incentive Payment System (MIPS)

Final score
78.57 of 100Reported as group
Quality
59.34
Promoting interoperability
89
Improvement activities
40
Cost
75.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
O1-0001580DEMDSpeech-Language Pathologist
07558MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Mar 10, 2022 Accepting new patients
Union Hospital of Cecil County CurrentSince Mar 10, 2022 Accepting new patients

Locations

111 W High St
Ste 303
Elkton, MD 21921
Phone (410) 392-2380

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

111 W High St
Ste 112
Elkton, MD 21921
Phone (410) 392-7027

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235543109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 SILVER LAKE BLVD",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199042410",
            "telephone_number": "410-312-7631",
            "fax_number": "410-510-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 SILVER LAKE BLVD",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199042410",
            "telephone_number": "410-312-7631",
            "fax_number": "410-510-1779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 E Cold Spring Ln",
            "address_2": "Rehab Department",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212393932",
            "country_code": "US",
            "telephone_number": "410-323-0500 x347",
            "fax_number": "443-548-0904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ERICA",
        "middle_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "07558",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "DE",
            "license": "O1-0001580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.