Kimberly A. Russo, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

L60A00549 Issued in DE

Practice address

1600 Rockland Road
Wilmington, DE 19803-3607

Phone

(302) 651-4200

Fax

(302) 651-5365

NPI assigned

May 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nemours New Jersey Physician Practice, P.C.

  • Pediatrics Physician
  • Deptford, NJ
  • NPI 1265874713
  Medicare reassignment NPD
• Shriners Hospitals for Children

  dba Shriners Children's Philadelphia

  • Pediatric Orthopaedic Surgery Physician
  • Philadelphia, PA
  • NPI 1659615706
  Medicare reassignment NPD
• STC Pediatrics LLC

  dba St. Christopher's Pediatric Associates Emergency Medicine - E. Erie A

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Philadelphia, PA
  • NPI 1144864547
  Medicare reassignment NPD
• Shriners Hospitals for Children

  dba Shriners Children's Hawaii

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD
• STC Pediatrics LLC

  dba St. Christopher's Pediatric Associates Immunology Specialist - Brodhea

  • Pediatric Allergy/Immunology Physician
  • Bethlehem, PA
  • NPI 1447894860
  NPD
• STC Pediatrics LLC

  dba St. Christopher's Pediatric Associates Ophthalmology - Newtown Yardley

  • Ophthalmology Physician
  • Newtown, PA
  • NPI 1548141997

  Pediatrics

  NPD

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1578500682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197230191",
            "telephone_number": "302-651-4000",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-4200",
            "fax_number": "302-651-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "RN336781L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN336781L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DE",
            "license": "L10036317",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "DE",
            "license": "L10036317",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DE",
            "license": "L60A00549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Russell
• Courtney Nicole Russell, M.A., BCBA
• Rebecca Jean Russell, MD
• Frances Russo-Avena
• John N Russo, DDS
• Nicholas J. Russo, D.M.D
• Sofia Danielle Russo, DO
• Gale Helen Rutan, MD
• Jane Choung Rutledge, D.M.D.
• Jeffrey Francis Rutledge, DMD

• Certified Registered Nurse Anesthetist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Certified Registered Nurse Anesthetist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.