Graycen Russell, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT2022-018 Issued in AR

Practice address

2100 W Main St
Russellville, AR 72801-2758

Phone

(479) 968-2525

Fax

(479) 968-2538

NPI assigned

Sep 20, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Graycen Perkins Former name

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

River Valley Therapy and Sports Medicine IncGroup PAC ID 1850294018, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• River Valley Therapy & Sports Medicine Inc

  • Physical Therapist
  • Russellville, AR
  • NPI 1619925732

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1316660921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012758",
            "telephone_number": "479-968-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012758",
            "telephone_number": "479-968-2525",
            "fax_number": "479-968-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "GRAYCEN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OT2022-018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "OT2022-018",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRAYCEN",
            "last_name": "PERKINS",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Russell B Allison MD PA
• Russell B Allison Mdpa
• Kayla Russell, RECOVERY ASSISTANT
• Russellville Cardiology Consultants, PA
• Russellville Care Center Inc
• Russellville Dermatology Clinic PA
• Russellville Ear Nose and Throat Surgery Clinic, P.a.

• Occupational Therapist in Russellville, AR
• Providers in Russellville, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.