Active NPI
Ruben Reginald Russell III, STNA
- Phlebotomy Technician
- Bedford HTS., OH
National Provider Identifier
1619212693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- OH23128M211
- Practice address
- 22091 Libby Rd Apt 101 Aa
Bedford HTS., OH 44146 - Phone
- (216) 392-3108
- NPI assigned
- Dec 3, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | OH23128M211 | OH | Primary |
Addresses
Primary practice location
22091 Libby Rd Apt 101 Aa
Bedford HTS., OH 44146
Mailing address
22091 Libby Rd Apt 101 Aa
Bedford HTS., OH 44146
Phone (216) 392-3108
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OH23128M211 | OH | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354492800000",
"number": "1619212693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22091 LIBBY RD APT 101 AA",
"city": "BEDFORD HTS.",
"state": "OH",
"postal_code": "44146",
"telephone_number": "216-392-3108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22091 LIBBY RD APT 101 AA",
"city": "BEDFORD HTS.",
"state": "OH",
"postal_code": "44146",
"telephone_number": "216-392-3108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "RUBEN",
"middle_name": "REGINALD",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "STNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-03",
"last_updated": "2012-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "OH",
"license": "OH23128M211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford HTS., OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.