Active NPI
Shonteria Russell
- Professional Counselor
- Sparta, TN
National Provider Identifier
1629511787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3786
- Practice address
- 755 Millers Point Rd
Sparta, TN 38583-1236 - Phone
- (931) 738-9906
- NPI assigned
- Nov 22, 2016
- Last updated
- Nov 22, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3786 | TN | Primary |
Addresses
Primary practice location
755 Millers Point Rd
Sparta, TN 38583-1236
Mailing address
755 Millers Point Rd
Sparta, TN 38583-1236
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479772800000",
"number": "1629511787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 MILLERS POINT RD",
"city": "SPARTA",
"state": "TN",
"postal_code": "385831236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 MILLERS POINT RD",
"city": "SPARTA",
"state": "TN",
"postal_code": "385831236",
"telephone_number": "931-738-9906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "SHONTERIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-22",
"last_updated": "2016-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "3786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparta, TN
- Rock House Medical Supply, LLC
- Rockin Smiles Dental PLLC
- Erin Whitney Rose, OTD, OTR/L
- Joseph Marc Ross, D.D.S.
- Julie Rowland
- Nancy Marie Rutherford, PT
- Sabra C Rinio (Sparta Discount Drugs)
- Sage Wellness Clinic, LLC
- Saint Thomas Highlands Hospital, LLC (Ascension Saint Thomas Highlands)
- Saint Thomas Highlands Hospital, LLC (Ascension Saint Thomas Highlands)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.