Russell Parker, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5513-24 Issued in WI

Practice address

2305 San Luis PL
Green Bay, WI 54304-5211

Phone

(920) 494-5231

Fax

(920) 494-2855

NPI assigned

Aug 18, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1376799643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 SAN LUIS PL",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045211",
            "telephone_number": "920-494-5231",
            "fax_number": "920-494-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 SAN LUIS PL",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045211",
            "telephone_number": "920-494-5231",
            "fax_number": "920-494-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5513-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela J Pardini, MD
• Yogesh C Pareek, M.D.
• Lisa M Parish, OTR
• Park Place Dental Care
• Sarah Sun Yee Park, DMD
• Parkview Manor Healthcare LLC
• Parkview Nursing and Rehab, LLC
• Alishia Parma
• Michael Parman, M.D.
• Vijay S Parmar, D.D.S.

• Physical Therapist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.