Dennis Micheal Russell, ATC, NRP

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT139 Issued in ME

Practice address

192 Russell St
Lewiston, ME 04240-5435

Phone

(207) 777-6006

NPI assigned

Dec 18, 2006

Last updated

Jun 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402790400000",
    "number": "1548323090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 RUSSELL ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405435",
            "telephone_number": "207-777-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 RUSSELL ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405435",
            "telephone_number": "207-777-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DENNIS",
        "middle_name": "MICHEAL",
        "name_prefix": "Mr.",
        "credential": "ATC, NRP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2014-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "ME",
            "license": "20114",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Royer, MD
• Steven Roland Royer, R.PH.
• Nicole Rucka
• Madeline Ruffin
• Jennifer A. Ruid, LCSW
• Lisa A Rutstein, MD
• Katelyn Ryan
• Lindsay Ryan
• Mikaela Ryan
• Karl Saba, D.O.

• Athletic Trainer in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Athletic Trainer in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2014; 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.