Active NPI
Joanne Russo
- Pediatric Physical Therapist
- Orange, CA
National Provider Identifier
1518253004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT 11241
- Practice address
- 960 W Town and Country Rd
Orange, CA 92868-4714 - Phone
- (714) 836-7886
- Fax
- (714) 836-1109
- NPI assigned
- Jun 22, 2011
- Last updated
- Jun 22, 2011
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT 11241 | CA | Primary |
Addresses
Primary practice location
960 W Town and Country Rd
Orange, CA 92868-4714
Mailing address
960 W Town and Country Rd
Orange, CA 92868-4714
Phone (714) 836-7886
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 |
|---|---|---|---|
| PT 11241 | CA | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Russo, Fleck & Associates | 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.
-
- Physical Therapy Clinic/Center
- Orange, CA
- NPI 1619263266
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1518253004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 W TOWN AND COUNTRY RD",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684714",
"telephone_number": "714-836-7886",
"fax_number": "714-836-1109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "960 W TOWN AND COUNTRY RD",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684714",
"telephone_number": "714-836-7886",
"fax_number": "714-836-1109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "JOANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-22",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "PT 11241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.