Katherine Y Russell, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704185467 Issued in MI

Practice address

30200 Telegraph Rd
Suite 220
Bingham Farms, MI 48025-4502

Phone

(248) 258-5058

NPI assigned

May 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Matrix Anesthesia PLC

  • Anesthesiology Physician
  • Saginaw, MI
  • NPI 1386922268
  Medicare reassignment NPD
• Prestige Anesthesia, PC

  • Anesthesiology Physician
  • Saginaw, MI
  • NPI 1689445959
  Medicare reassignment NPD
• Northstar Anesthesia of Michigan II PC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1437268026

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• American Anesthesiology Associates of Michigan, PC

  • Anesthesiology Physician
  • Grand Blanc, MI
  • NPI 1235181223

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1629036017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28129 BROOKHILL ST",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30200 TELEGRAPH RD",
            "address_2": "SUITE 220",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254502",
            "telephone_number": "248-258-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KATHERINE",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704185467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104831330",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N78650084",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N47230634",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trilana Marcesha Rumely
• Grace E Rummler
• Delena Lashae Rusan
• Desiray Chante Rush
• Karen R. Russell-Little, M.D.
• Tanisha Russell Lanette Russell
• Kelsey Anne Russom, MS
• Sarah Lynne Ruster
• Kelly Elizabeth Rutter
• S D Consulting Inc

• Certified Registered Nurse Anesthetist in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.