Debra G Russell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

MO076908 Issued in MO

Practice address

225 Physicians Park Ste 203
Poplar Bluff, MO 63901-3921

Phone

(573) 686-4750

Fax

(573) 686-4753

NPI assigned

Feb 9, 2006

Last updated

Aug 31, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)
• Pain Management Interventions, LLC

  • Interventional Pain Medicine Physician
  • Valparaiso, IN
  • NPI 1700849247
  NPD (past)

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1255304440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639020699",
            "telephone_number": "573-686-4750",
            "fax_number": "573-686-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK STE 203",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013921",
            "telephone_number": "573-686-4750",
            "fax_number": "573-686-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DEBRA",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "MO076908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425335809",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rural-Metro Mid-South LP
• Scott D Rush
• Rushin Chiropractic PC (Rushin Chiropractic Center)
• Jack Douglas Rushin, D.C.
• Alexandra Denise Russell, DPT
• Shilo Russell
• Victoria Russell
• Jessica Elizabeth Russom
• Wyatt Russom
• Mercy Rathini Sabapathypillai, M.D.

• Family Nurse Practitioner in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.