NPIMap

Individual provider Active NPI

Valeri Renee Russell

  • Physician Assistant
  • Miles City, MT
National Provider Identifier
1578893418
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
600 Issued in MT
Practice address
2600 Wilson St
Miles City, MT 59301-5094
Phone
(406) 233-2600
NPI assigned
Dec 26, 2009
Last updated
Mar 4, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 600 MT Primary

Addresses

Primary practice location

2600 Wilson St
Miles City, MT 59301-5094

Mailing address

2600 Wilson St
Miles City, MT 59301-5094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100526001081 MT Practitioner - Physician Assistant 6507991981 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1202 3Rd St W
Roundup, MT 59072-1816
Phone (406) 323-2301

1207 2ND St W
Roundup, MT 59072-1835
Phone (406) 323-2301

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
600MTMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Rosary Healthcare CurrentSince Jan 26, 2010 Accepting new patients
Roundup Memorial Hospital Association CurrentSince Mar 2, 2016 Accepting new patients
Holy Rosary Healthcare CurrentSince Jan 26, 2010 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

2600 Wilson St
Miles City, MT 59301
Phone (406) 233-2500

1202 3rd St W
Roundup, MT 59072
Phone (406) 323-2301

1207 2nd St W
Roundup, MT 59072
Phone (406) 323-2301

Organizations & group practices 6

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1261785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1578893418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 WILSON ST",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593015094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 WILSON ST",
            "city": "MILES CITY",
            "state": "MT",
            "postal_code": "593015094",
            "telephone_number": "406-233-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "VALERI",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-26",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miles City, MT

Sources for this page

Verify at the official NPI Registry.