Active NPI
Natalie Eleni Russell
- Physical Therapist
- Oakland, CA
National Provider Identifier
1457832578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 295322
- Practice address
- 3701 Broadway
Oakland, CA 94611-5613 - Phone
- (510) 752-6179
- NPI assigned
- Aug 27, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 295322 | CA | Primary |
Addresses
Primary practice location
3701 Broadway
Oakland, CA 94611-5613
Mailing address
14 Camp St
San Francisco, CA 94110-1119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 295322 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Origin Physical Therapy Ca Inc | Physical Therapist | Current | Accepting new patients |
Locations
2915 Telegraph Ave
Ste 302
Berkeley, CA 94705
Phone (305) 510-4167
7188 Avenida Encinas
Ste 110
Carlsbad, CA 92011
1800 Filbert St
San Francisco, CA 94123
Phone (628) 207-0990
Organizations & group practices 1
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.
-
- Physical Therapist
- Los Angeles, CA
- NPI 1982169595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535328000000",
"number": "1457832578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 CAMP ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941101119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 BROADWAY",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115613",
"telephone_number": "510-752-6179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "NATALIE",
"middle_name": "ELENI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-27",
"last_updated": "2018-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "295322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.