Active NPI
Michele Ann Russell, OTR
- Occupational Therapist
- Colorado Springs, CO
National Provider Identifier
1427323211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 987
- Practice address
- 1605 Elm Creek VW
Colorado Springs, CO 80907-7181 - Phone
- (719) 633-2701
- NPI assigned
- Mar 13, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 987 | CO | Primary |
Addresses
Primary practice location
1605 Elm Creek VW
Colorado Springs, CO 80907-7181
Mailing address
25117 SW Parkway Ave
Suite D
Wilsonville, OR 97070-9697
Phone (971) 224-2037
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 987 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331596800000",
"number": "1427323211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25117 SW PARKWAY AVE",
"address_2": "SUITE D",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970709697",
"telephone_number": "971-224-2037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 ELM CREEK VW",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809077181",
"telephone_number": "719-633-2701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "MICHELE",
"middle_name": "ANN",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-13",
"last_updated": "2012-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.