Ivory Russ

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

31101007 Issued in FL

Practice address

300 Summer Breeze Way Apt 1106
St Augustine, FL 32086-1804

Phone

(912) 342-9829

NPI assigned

Dec 5, 2022

Last updated

Jan 30, 2023By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1255042826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SUMMER BREEZE WAY APT 1106",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320861804",
            "telephone_number": "912-342-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SUMMER BREEZE WAY APT 1106",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320861804",
            "telephone_number": "912-342-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "IVORY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "31101007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jearlean Ruiz Marin, PSY.D.
• Rural Health Care Inc. (Aza Health)
• Rural Health Care, Incorporated (Aza Health)
• Rural Health Care, Incorporated (Aza Health)
• Jennifer Lynn Rusich
• Russell Denea, MD, LLC
• Caitlin Owen Russell
• Helena Russell, APRN
• Valerie A Russell, LCSW
• Alexandra Russick, RBT

• Home Health Agency in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.