Russell Psychiatry, Professional Limited Liability Company

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

Q6697 Issued in TX

Legal business name

RUSSELL PSYCHIATRY, PROFESSIONAL LIMITED LIABILITY COMPANY

Practice address

2006 S Loop 336 W Ste 500
Conroe, TX 77304-3315

Phone

(817) 726-9444

NPI assigned

Mar 28, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Stacey Russell, MDNPI 1275945511

Title

Manager/Lead Psychiatrist

Phone

(817) 726-9444

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacey Russell, M.D.

  • Psychiatry Physician
  • Conroe, TX
  • NPI 1275945511
  Medicare reassignment Authorized official
• Chantell Hebert

  • Clinical Social Worker
  • Conroe, TX
  • NPI 1265889836
  NPD (past)

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1356846729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 S LOOP 336 W STE 500",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 S LOOP 336 W STE 500",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043315",
            "telephone_number": "817-726-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL PSYCHIATRY, PROFESSIONAL LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "MANAGER/LEAD PSYCHIATRIST",
        "authorized_official_telephone_number": "817-726-9444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "Q6697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI DR. STACEY RUSSELL",
            "identifier": "1275945511",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Ruiz
• Jessica Marie Ruiz, LPC
• Edward L Ruppenthal, PA
• Jessica Rushing, PA-C
• Jasirae Rusk, LPC
• Stacey Russell, M.D.
• Landon Russo
• Robin Moore Ruzic
• Catherine Hope Ruzzi, RN
• Daniel Sacaciu

• Psychiatry Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.

Verify at the official NPI Registry.