Olivia Russell

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

029974 Issued in NY

Practice address

171 E Hoard St
Watertown, NY 13601-1500

Phone

(315) 785-3750

NPI assigned

Aug 18, 2020

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1417569823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S JAMES ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191516",
            "telephone_number": "315-783-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 E HOARD ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011500",
            "telephone_number": "315-785-3750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1335 Washington St",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136014591",
            "country_code": "US",
            "telephone_number": "315-785-3810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2023-01-30",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin David Rudd, MD
• Francesca Carmen Ruddy, MS, OTR/L
• Pearl Leanne Rumsey
• Mary Runge, BA, MS CCC-SLP
• Debra Lynne Russell, RN
• Jennifer H Rutledge, OTR/L
• Mark Alan Rutledge, OTR
• Carlice Cecil Ruttan II, LCSW
• Corey Douglas Ryan, OD
• S.T.a.T Communications, Inc

• All providers in Watertown, NY
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.