Active NPI
Ana M Russe, LCDA.
- Nutritionist
- Manati, PR
National Provider Identifier
1396760435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 765
- Practice address
- Urb. Atenas Marginal Elliot Velez
J-20
Manati, PR 00674 - Phone
- (787) 884-8923
- Fax
- (787) 884-8923
- NPI assigned
- Jul 12, 2006
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 765 | PR | Primary |
Addresses
Primary practice location
Urb. Atenas Marginal Elliot Velez
J-20
Manati, PR 00674
Mailing address
PO Box 443
Morovis, PR 00687-0443
Phone (787) 862-5368
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 765 | PR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396760435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 443",
"city": "MOROVIS",
"state": "PR",
"postal_code": "006870443",
"telephone_number": "787-862-5368",
"fax_number": "787-862-5368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "URB. ATENAS MARGINAL ELLIOT VELEZ",
"address_2": "J-20",
"city": "MANATI",
"state": "PR",
"postal_code": "00674",
"telephone_number": "787-884-8923",
"fax_number": "787-884-8923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSE",
"first_name": "ANA",
"middle_name": "M",
"credential": "LCDA.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "PR",
"license": "765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manati, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.