Individual provider Active NPI

Katrin Russ, LMT

  • Massage Therapist
  • Tallahassee, FL
National Provider Identifier
1629364880
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60775 Issued in FL
Practice address
1304 E 6TH Ave
Tallahassee, FL 32303-6506
Phone
(850) 224-2242
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60775 FL Primary

Addresses

Primary practice location

1304 E 6TH Ave
Tallahassee, FL 32303-6506

Mailing address

1304 E 6TH Ave
Tallahassee, FL 32303-6506
Phone (850) 224-2242

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

LicenseStateTypeSpecialty
MA60775FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1629364880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 E 6TH AVE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036506",
            "telephone_number": "850-224-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 E 6TH AVE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036506",
            "telephone_number": "850-224-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "KATRIN",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA60775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.