Individual provider Active NPI

Melissa Russell, LPN

  • Licensed Practical Nurse
  • Port St Lucie, FL
National Provider Identifier
1285512293
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
5221802 Issued in FL
Practice address
974 SW Curtis St
Port St Lucie, FL 34983-1906
Phone
(954) 822-4663
NPI assigned
Aug 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 5221802 FL Primary

Addresses

Primary practice location

974 SW Curtis St
Port St Lucie, FL 34983-1906

Mailing address

4371 Northlake Blvd # 152
N Palm Beach, FL 33410-6253
Phone (954) 822-4663

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5221802FLMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1285512293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 NORTHLAKE BLVD # 152",
            "city": "N PALM BEACH",
            "state": "FL",
            "postal_code": "334106253",
            "telephone_number": "954-822-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 SW CURTIS ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831906",
            "telephone_number": "954-822-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MELISSA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "5221802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.