Individual provider Active NPI

Cristin Aileen Camaione-Russell, MS,PT

  • Pediatric Physical Therapist
  • Jacksonville, NC
National Provider Identifier
1528240223
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
10061 Issued in NC
Practice address
410 New Bridge St
Suite 10a
Jacksonville, NC 28540-4739
Phone
(910) 347-2212
NPI assigned
Dec 4, 2007
Last updated
Dec 4, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 10061 NC Primary

Addresses

Primary practice location

410 New Bridge St
Suite 10a
Jacksonville, NC 28540-4739

Mailing address

410 New Bridge St
Suite 10a
Jacksonville, NC 28540-4739
Phone (910) 347-2212

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
10061NCMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
J.Z. Mann Pediatric Therapy, Inc. 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": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1528240223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 NEW BRIDGE ST",
            "address_2": "SUITE 10A",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404739",
            "telephone_number": "910-347-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 NEW BRIDGE ST",
            "address_2": "SUITE 10A",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404739",
            "telephone_number": "910-347-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMAIONE-RUSSELL",
        "first_name": "CRISTIN",
        "middle_name": "AILEEN",
        "credential": "MS,PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "10061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.