Active NPI
Charlotte Elizabeth Russell, CPM
- Midwife
- Marshall, TX
National Provider Identifier
1487875159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 06001
- Practice address
- 404 University Ave
Marshall, TX 75670-5262 - Phone
- (318) 272-8295
- NPI assigned
- May 1, 2007
- 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 |
|---|---|---|---|---|
| Midwife | 176B00000X | 06001 | TX | Primary |
Addresses
Primary practice location
404 University Ave
Marshall, TX 75670-5262
Mailing address
404 University Ave
Marshall, TX 75670-5262
Phone (318) 272-8295
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06001 | TX | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edenway Birth Center | Past | Accepting new patients |
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.
-
- Birthing Clinic/Center
- Marshall, TX
- NPI 1932334927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361145600000",
"number": "1487875159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 UNIVERSITY AVE",
"city": "MARSHALL",
"state": "TX",
"postal_code": "756705262",
"telephone_number": "318-272-8295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 UNIVERSITY AVE",
"city": "MARSHALL",
"state": "TX",
"postal_code": "756705262",
"telephone_number": "318-272-8295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "CHARLOTTE",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "CPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2013-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "TX",
"license": "06001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.