Jodi Russell, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

26016939A Issued in IN

Practice address

2 S Broadway
Peru, IN 46970-2232

Phone

(765) 472-4367

NPI assigned

Nov 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• Hook-Superx LLC

  • Pharmacy
  • Peru, IN
  • NPI 1295838910
  NPD (past)

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1598368847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 AVALON DR",
            "city": "GREENTOWN",
            "state": "IN",
            "postal_code": "469361608",
            "telephone_number": "176-543-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S BROADWAY",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469702232",
            "telephone_number": "765-472-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JODI",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26016939A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cvs",
            "affiliation": "N",
            "address_1": "2 S Broadway",
            "city": "Peru",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469702232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacob Rombold, PTA
• Ana Rosales
• Betsy Rosiek, M.D.
• Lacey Renee Rosinski, NP
• Christina Russell, BS, MA STUDENT
• John Savage, MD
• Yoko Savino, DO
• Roderick J Sawyer, MD
• Ashley Saylor
• Michele Annette Schaeffer, RN, PMHNP

• Pharmacist in Peru, IN
• Providers in Peru, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.