Active NPI
Marianna Vladimirovna Russu, R.T.(R)
- Radiologic Technologist
- Loganville, GA
National Provider Identifier
1376342824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- I089047
- Practice address
- 3800 Michaels Creek Way
Loganville, GA 30052-5183 - Phone
- (510) 695-4721
- NPI assigned
- Mar 10, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | I089047 | Primary |
Addresses
Primary practice location
3800 Michaels Creek Way
Loganville, GA 30052-5183
Mailing address
3800 Michaels Creek Way
Loganville, GA 30052-5183
Phone (510) 695-4721
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741564800000",
"number": "1376342824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 MICHAELS CREEK WAY",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300525183",
"telephone_number": "510-695-4721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 MICHAELS CREEK WAY",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300525183",
"telephone_number": "510-695-4721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSU",
"first_name": "MARIANNA",
"middle_name": "VLADIMIROVNA",
"credential": "R.T.(R)",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-10",
"last_updated": "2025-03-10",
"certification_date": "2025-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiologic Technologist",
"state": null,
"license": "I089047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loganville, GA
- Lindsey Danae Rooks, LPN
- Teresa Rosser, FNP-C
- Royal J Palace Home Care, LLC
- Ruan Surgical Services
- Jocelyn Rushin
- Rutledge Pharmacy and Medical Supplies LLC (Rutledge Pharmacy and Medical Supplies)
- Sacredspace Psychotherapy, LLC
- Sage Dental Group of Georgia, LLC (Sage Dental of Loganville)
- Denise Nabouro Samassa
- Derica N. Sams, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.