Russmann, Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

RUSSMANN, INC.

Doing business as

Tennessee MedPort

Practice address

4163 Benny Delozier Drive
Maryville, TN 37804

Phone

(865) 379-9850

NPI assigned

Sep 15, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Brenda Russell Bodemann

Title

Principal

Phone

(865) 414-2779

Specialties & licenses 1

Addresses

Other names 1

• Tennessee MedPort Doing business as

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1407138381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4163 BENNY DELOZIER DRIVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-379-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4163 BENNY DELOZIER DRIVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-379-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSMANN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "BODEMANN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "865-414-2779",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennessee MedPort",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eugene Peter Runne, D.C.
• Nathaniel Runne, M.D.
• Alexandria Russell
• Chris Russell, MSSW
• Dana Mariea Russell, FNP-BC
• Robert Steven Ruth, LCSW
• Rachel Ryan McMillan, LPC-MHSP, ATR-BC
• Teresa M Salazar-Catron, MD
• Maribeth Salinas
• Nalini Samavedy, MD

• Land Ambulance in Maryville, TN
• Providers in Maryville, TN by specialty
• Land Ambulance in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.