Active NPI
Keith Russell, PT, DPT
- Physical Therapist
- Greenville, NC
National Provider Identifier
1275798480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11680
- Practice address
- 1330 E Arlington Blvd
Suite a
Greenville, NC 27858-7850 - Phone
- (252) 758-7048
- Fax
- (252) 215-5614
- NPI assigned
- Jul 28, 2008
- Last updated
- Jul 28, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11680 | NC | Primary |
Addresses
Primary practice location
1330 E Arlington Blvd
Suite a
Greenville, NC 27858-7850
Mailing address
1330 E Arlington Blvd
Suite a
Greenville, NC 27858-7850
Phone (252) 758-7048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11680 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedics East & Sports Medicine Center, Inc. | Current | Accepting new patients | |
| Careworks, LLC | Physical Therapist | Past | Accepting new patients |
| Careworks, LLC | Physical Therapist | Past | Accepting new patients |
Locations
810 Wh Smith Blvd
Greenville, NC 27834
Phone (252) 757-2663
Organizations & group practices 3
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.
-
- Specialist
- Greenville, NC
- NPI 1780655803
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217203200000",
"number": "1275798480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 E ARLINGTON BLVD",
"address_2": "SUITE A",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278587850",
"telephone_number": "252-758-7048",
"fax_number": "252-215-5614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 E ARLINGTON BLVD",
"address_2": "SUITE A",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278587850",
"telephone_number": "252-758-7048",
"fax_number": "252-215-5614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "KEITH",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-28",
"last_updated": "2008-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "11680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.