Tamika Jean Russavage

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

69653 Issued in NE

Practice address

1807 S 60TH St
Omaha, NE 68106-2151

Phone

(531) 299-1080

Fax

(531) 299-1099

NPI assigned

Oct 18, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1316768823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14568 CORBY ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681165104",
            "telephone_number": "402-334-8369",
            "fax_number": "531-299-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 S 60TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681062151",
            "telephone_number": "531-299-1080",
            "fax_number": "531-299-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSAVAGE",
        "first_name": "TAMIKA",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "69653",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NE",
            "license": "69653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katina Russ
• Makeda Russ
• Quantrell Russ
• Tashauna Russ
• Toriann Russ
• Antoinette L Russell-Smith
• Alisha Russell
• Allison Russell, CRNA
• Amber Russell
• Ann B Russell, M.D.

• School Registered Nurse in Omaha, NE
• Providers in Omaha, NE by specialty
• School Registered Nurse in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.