Individual provider Active NPI

Reva Michelle Russ, FNP

  • Family Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1609536317
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024183254 Issued in VA
Practice address
5855 Bremo Rd Ste 706
Richmond, VA 23226-1926
Phone
(804) 287-4528
NPI assigned
Dec 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024183254 VA Primary

Addresses

Primary practice location

5855 Bremo Rd Ste 706
Richmond, VA 23226-1926

Mailing address

111 Moore Ave
Colonial Heights, VA 23834-1311
Phone (048) 475-2858

Other names 1

  • Reva Michelle Rodas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220810002878 VA Practitioner - Nurse Practitioner 5092198952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

5855 Bremo Rd
Richmond, VA 23226-1924

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Aug 20, 2025 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Aug 20, 2025 Accepting new patients

Locations

4600 McAuley Pl
Ste 600
Blue Ash, OH 45242
Phone (513) 752-8000

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5855 Bremo Rd
Ste 706
Richmond, VA 23226
Phone (804) 287-4528

Interoperability endpoints

  • Direct secure messaging: rruss2943708@direct.bsmhealth.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1609536317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MOORE AVE",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341311",
            "telephone_number": "048-475-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 BREMO RD STE 706",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261926",
            "telephone_number": "804-287-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "REVA",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-21",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024183254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REVA",
            "last_name": "RODAS",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.