Dorothea D Russell, RN, MS, CNP

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

R0611606 Issued in MN

Practice address

2828 Chicago Ave South
Suite 200
Minneapolis, MN 55407-1320

Phone

(612) 879-1000

Fax

(612) 879-9116

NPI assigned

Jun 8, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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.

• Quest Diagnostics LLC Il

  • Clinical Medical Laboratory
  • Chicago, IL
  • NPI 1669298055
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1508860578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 CHICAGO AVE SOUTH",
            "address_2": "SUITE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071320",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 CHICAGO AVE SOUTH",
            "address_2": "SUITE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071320",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DOROTHEA",
        "middle_name": "D",
        "credential": "RN, MS, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "R0611606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303664200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharine Noelle Rush, PT, DPT
• Kayci Rose Rush, LICSW
• Robert Rusnak
• Alan L Russell, DDS
• Catherine Lenore Russell, MSW, LICSW
• Evelyn Ruth Russell, PT
• Holly Ann Russell, RD
• Naijia Russell
• Sarah Russell
• Shane Russell, LICSW

• Neurology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Neurology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.