Shannan R Russ, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F332653 Issued in NY

Practice address

1005 Walnut St
Elmira, NY 14901-1007

Phone

(607) 734-3968

Fax

(833) 450-5884

NPI assigned

Jan 22, 2007

Last updated

Mar 20, 2025By the provider in NPPES

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

Other identifiers 1

Other names 1

• Shannan R Hamilton Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Saginaw Valley Medical College - NLG, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Chautauqua Center IncGroup PAC ID 7214178326, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22211/brand/1/csg/1/fhir/r4
• Direct secure messaging: shannan.russ.1@22211.direct.athenahealth.com

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

• The Chautauqua Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Dunkirk, NY
  • NPI 1760747521
  Medicare reassignment Care Compare group NPD
• The Chautauqua Center, Inc

  • Gynecology Physician
  • Elmira, NY
  • NPI 1326817693
  NPD
• Chautauqua PT OT & SLP Professionals PLLC

  dba Chautauqua Physical & Occupational Therapy

  • Specialist
  • Jamestown, NY
  • NPI 1710910690
  NPD (past)
• Chemung Medical Services PC

  dba Arnot Medical Services

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1356378889
  NPD (past)
• Fort Edward Rescue Squad Inc

  • Ambulance
  • Fort Edward, NY
  • NPI 1427031319
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1457405144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 WALNUT ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149011007",
            "telephone_number": "607-734-3968",
            "fax_number": "833-450-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 WALNUT ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149011007",
            "telephone_number": "607-734-3968",
            "fax_number": "833-450-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "SHANNAN",
        "middle_name": "R",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02001921",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNAN",
            "last_name": "HAMILTON",
            "middle_name": "R",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaitlyn Rugiero
• Kaylie Rumon, LPN
• Geraldine Rumpf, CRNA
• Kathleen Rundle
• Aleksander Jozef Rupik, M.D.
• Samuel J Russell, RPAC
• Stephanie Nicole Russell, AGPCNP
• Amanda Rutty
• Kelly Lynn Ryan, PT, DPT
• Meagan Sabatini

• Family Nurse Practitioner in Elmira, NY
• Providers in Elmira, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.