Individual provider Active NPI

Kasie L Russell, ARNP

  • Adult Health Nurse Practitioner
  • Zephyrhills, FL
National Provider Identifier
1366629123
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
9268544 Issued in FL
Practice address
38176 Medical Center Ave
Zephyrhills, FL 33540-1380
Phone
(813) 444-7311
Fax
(813) 488-0011
NPI assigned
Jan 23, 2008
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 9268544 FL Primary
Primary Care Nurse Practitioner 363LP2300X 9268544 FL

Addresses

Primary practice location

38176 Medical Center Ave
Zephyrhills, FL 33540-1380

Mailing address

PO Box 7062
Wesley Chapel, FL 33545-0100
Phone (813) 444-7311

Other practice location 1

4312 Rustic Pine Pl
Wesley Chapel, FL 33544-8849
Phone (813) 991-7361

Other identifiers 1

IdentifierTypeStateIssuer
9268544OtherFLAPRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080402000866 FL Practitioner - Nurse Practitioner 5395822233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

38176 Medical Ctr Ave
Zephyrhills, FL 33540-1380
Phone (813) 444-7311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9268544FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Images Medical Clinic PA Adult Health CurrentSince Nov 6, 2020 Accepting new patients
Advanced Pain Management Center, Inc. Past Accepting new patients

Locations

38176 Medical Center Ave
Zephyrhills, FL 33540
Phone (813) 444-7311

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FECIDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/FECIDD/Endpoint/FECIDD

Organizations & group practices 2

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366629123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7062",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335450100",
            "telephone_number": "813-444-7311",
            "fax_number": "813-488-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38176 MEDICAL CENTER AVE",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335401380",
            "telephone_number": "813-444-7311",
            "fax_number": "813-488-0011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4312 Rustic Pine Pl",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335448849",
            "country_code": "US",
            "telephone_number": "813-991-7361",
            "fax_number": "813-991-7361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KASIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2023-03-07",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9268544",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "9268544",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "9268544",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.