Active NPI
Hannah B Russell, PA-C
- Physician Assistant
- Lewiston, MI
National Provider Identifier
1346601127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601007662
- Practice address
- 3040 Bourn St
Lewiston, MI 49756-8134 - Phone
- (989) 786-4877
- Fax
- (989) 786-2187
- NPI assigned
- Mar 8, 2016
- Last updated
- Mar 8, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601007662 | MI | Primary |
Addresses
Primary practice location
3040 Bourn St
Lewiston, MI 49756-8134
Mailing address
850 N Otsego Ave
Suite 1
Gaylord, MI 49735-1568
Phone (989) 731-7708
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0F96004 | Other | MI | GROUP MEDICARE |
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
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457395200000",
"number": "1346601127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 N OTSEGO AVE",
"address_2": "SUITE 1",
"city": "GAYLORD",
"state": "MI",
"postal_code": "497351568",
"telephone_number": "989-731-7708",
"fax_number": "989-731-7929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3040 BOURN ST",
"city": "LEWISTON",
"state": "MI",
"postal_code": "497568134",
"telephone_number": "989-786-4877",
"fax_number": "989-786-2187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "HANNAH",
"middle_name": "B",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-08",
"last_updated": "2016-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601007662",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE",
"identifier": "0F96004",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, MI
- Munson Healthcare Otsego Memorial Hospital (Munson Healthcare OMH Medical Group-Lewiston)
- Jessica Neuroth
- Rite Aid
- Rite Aid of Michigan Inc (RITE AID Pharmacy 02683)
- Rite Aid Pharmacy
- Stephanie Rutterbush, MD
- Sheppard Dental Group LLC
- Lisa Ann Stier, NP-C
- Thunder Bay Community Health Service, Inc (Lewiston Elementary School)
- Thunder Bay Community Health Service, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.