Roger A Russell, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2-2996 Issued in TX

Practice address

1049 N 3Rd St
Ste 505
Abilene, TX 79601-5833

Phone

(325) 672-8883

Fax

(325) 675-5833

NPI assigned

Aug 4, 2005

Last updated

Jan 19, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Texas a & M University System, HSC, College of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Key City Psychology

  • Community/Behavioral Health Agency
  • Abilene, TX
  • NPI 1922986579
  NPD (past)

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1396746947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 N 3RD ST",
            "address_2": "STE 505",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796015833",
            "telephone_number": "325-672-8883",
            "fax_number": "325-675-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 N 3RD ST",
            "address_2": "STE 505",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796015833",
            "telephone_number": "325-672-8883",
            "fax_number": "325-675-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ROGER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "2-2996",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "873LMFT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0971830-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rae Ellen Rupp, OD
• Rene Rushatsi
• Russell F. Burns M.D. P.a.
• Russell Liles, O.D., PLLC (Elite Eyecare of Abilene)
• Russell S Dickerson MD
• Marsha Dawn Rutland, PT
• Neelima Ryali, M.D.
• S.U.R. LLC (Abilene Nursing and Rehabilitation Center)
• Macarena Andrea Saavedra Olguin
• Todd D Sage, OTR

• Psychologist in Abilene, TX
• Providers in Abilene, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.