Active NPI
Jessica Russell, NP
- Family Nurse Practitioner
- Raleigh, NC
National Provider Identifier
1255696449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5005735
- Practice address
- 726 N Blount St
Raleigh, NC 27604-1124 - Phone
- (919) 213-1029
- NPI assigned
- Jul 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 226111 | NC | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 5005735 | NC | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | C-APN.0101787-C-NP | CO | |
| Family Nurse Practitioner | 363LF0000X | 5005735 | NC | Primary |
Addresses
Primary practice location
726 N Blount St
Raleigh, NC 27604-1124
Mailing address
3064 Wake Forest Rd # 1365
Raleigh, NC 27609-7844
Phone (919) 297-8343
Other practice location 1
3030 S College Ave Unit 210
Fort Collins, CO 80525-2557
Phone (919) 213-1029
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 226111 | NC | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785283200000",
"number": "1255696449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3064 WAKE FOREST RD # 1365",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097844",
"telephone_number": "919-297-8343",
"fax_number": "919-213-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 N BLOUNT ST",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276041124",
"telephone_number": "919-213-1029"
}
],
"practiceLocations": [
{
"address_1": "3030 S College Ave Unit 210",
"address_purpose": "LOCATION",
"city": "Fort Collins",
"state": "CO",
"postal_code": "805252557",
"country_code": "US",
"telephone_number": "919-213-1029",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSELL",
"first_name": "JESSICA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-12",
"last_updated": "2026-07-29",
"certification_date": "2026-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "226111",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NC",
"license": "5005735",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CO",
"license": "C-APN.0101787-C-NP",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5005735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.