Active NPI
Kelsey Lynne Russo, PT
- Physical Therapist
- Columbus, IN
National Provider Identifier
1497182463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05011301A
- Practice address
- 2625 Foxpointe Drive
Columbus, IN 47203 - Phone
- (812) 314-2378
- NPI assigned
- Oct 4, 2013
- Last updated
- Nov 21, 2013
- 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 | 05011301A | IN | Primary |
Addresses
Primary practice location
2625 Foxpointe Drive
Columbus, IN 47203
Mailing address
2625 Foxpointe Drive
Columbus, IN 47203
Phone (812) 314-2378
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 |
|---|---|---|---|
| 05011301A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Step Ahead Pediatric Therapy | Physical Therapist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384992000000",
"number": "1497182463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 FOXPOINTE DRIVE",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "47203",
"telephone_number": "812-314-2378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 FOXPOINTE DRIVE",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "47203",
"telephone_number": "812-314-2378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "KELSEY",
"middle_name": "LYNNE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-04",
"last_updated": "2013-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05011301A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.