Randall Loyd Russell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05073 Issued in LA

Practice address

5958 Saint Bernard Ave
New Orleans, LA 70122-1324

Phone

(601) 206-9195

NPI assigned

Dec 30, 2024

Sex

Male

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)

Not enrolled

State licenses

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.

• Trinity Rehabilitation Inc

  • Physical Therapist
  • Jackson, MS
  • NPI 1588759369
  NPD (past)

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1255149753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 NORTHTOWN DR STE 110",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113047",
            "telephone_number": "601-206-9195",
            "fax_number": "601-957-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5958 SAINT BERNARD AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701221324",
            "telephone_number": "601-206-9195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 Northtown Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392113047",
            "country_code": "US",
            "telephone_number": "601-206-9195",
            "fax_number": "601-957-8391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "RANDALL",
        "middle_name": "LOYD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "05073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antoine Russell, OTR/L
• Brianisha Russell
• Dwayne Russell
• Karyn Russell, PLPC
• Nicole Marie Russell
• Rebecca Russell, MSW, LCSW-BACS
• Shanya M. Russell
• Emilio Anthony Russo, MD
• Karen Spako Russo, LPC
• Melissa B Russo, M.D.

• Physical Therapist in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.