Individual provider Active NPI

Jessica Russell, NP

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1255696449
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5005735 Issued in NC
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

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
226111NCMDFamily 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.

Verify at the official NPI Registry.