Individual provider Active NPI

Kristen Yaeger Russo, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Tallmadge, OH
National Provider Identifier
1457963365
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0026780 Issued in OH
Practice address
116 East Ave Ste 3
Tallmadge, OH 44278-2300
Phone
(330) 633-7782
Fax
(330) 633-4701
NPI assigned
Aug 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0026780 OH Primary

Addresses

Primary practice location

116 East Ave Ste 3
Tallmadge, OH 44278-2300

Mailing address

116 East Ave Ste 3
Tallmadge, OH 44278-2300
Phone (330) 633-7782

Other identifiers 1

IdentifierTypeStateIssuer
0416557MedicaidOH

Other names 1

  • Kristen Ann Yaeger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20200827001537 OH Practitioner - Nurse Practitioner 4183041775 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unity Health Network LLCGroup PAC ID 0244379717, 59 clinicians

Practice addresses (Care Compare)

116 E Ave
Suite 3
Tallmadge, OH 44278-2300
Phone (330) 633-7782

Hospital & facility affiliations

  • Summa Western Reserve Hospital Hospital, Cuyahoga Falls, OH, CCN 360150
  • Summa Health System Hospital, Akron, OH, CCN 360020
  • Akron General Medical Center Hospital, Akron, OH, CCN 360027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
0026780OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince Sep 16, 2020 Accepting new patients
Unity Health Network, LLC CurrentSince Oct 31, 2021 Accepting new patients
Unity Health Network, LLC CurrentSince Oct 31, 2021 Accepting new patients

Locations

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

3033 State Rd
Ste 204
Cuyahoga Fls, OH 44223
Phone (330) 253-9727

3033 State Rd
Ste 101
Cuyahoga Fls, OH 44223
Phone (330) 923-8372

1900 23rd St
Cuyahoga Fls, OH 44223
Phone (330) 929-2685

307 W Main St
Ste B
Kent, OH 44240
Phone (330) 678-7782

116 East Ave
Ste 3
Tallmadge, OH 44278
Phone (330) 633-7782

7345 State Route 3
Westerville, OH 43082
Phone (614) 794-5550

Interoperability endpoints

  • Direct secure messaging: kristen.yaeger@wrhs.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1457963365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 EAST AVE STE 3",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782300",
            "telephone_number": "330-633-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 EAST AVE STE 3",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782300",
            "telephone_number": "330-633-7782",
            "fax_number": "330-633-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "KRISTEN",
        "middle_name": "YAEGER",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-21",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0026780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0416557",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "YAEGER",
            "middle_name": "ANN",
            "credential": "MSN, APRN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tallmadge, OH

Sources for this page

Verify at the official NPI Registry.