Era Russell, HAIR LOSS SPECIALIST

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

224P00000X Issued in GA

Practice address

2170 W Point Rd
Suite 36
Lagrange, GA 30240-4007

Phone

(762) 323-7874

NPI assigned

Apr 19, 2016

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Artisan Beauty Salon LLC

  • Prosthetic/Orthotic Supplier
  • Lagrange, GA
  • NPI 1649935065
  NPD Authorized official

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1447604178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 W POINT RD",
            "address_2": "SUITE 36",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404007",
            "telephone_number": "762-323-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 W POINT RD",
            "address_2": "SUITE 36",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404007",
            "telephone_number": "762-323-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ERA",
        "credential": "HAIR LOSS SPECIALIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2021-11-01",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "GA",
            "license": "224P00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7708",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Anne Roe, DPT
• Sharlotte Yvette Rogers, LPC
• Kasey Ross
• Jessica Siggers Rounds
• Tabithia Renee Rowland
• Sager Inc.
• Patricia Ann Salter, DMD
• Pamela Teresa Sampson, NP
• Kolby Sanchez, S/T, MA
• Collin Taylor Sanders-Lamoree, LAPC

• Prosthetist in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Prosthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.