Individual provider Active NPI

Tamala Russell, MSN

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1639414337
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9270405 Issued in FL
Practice address
11200 SW 8TH St
Miami, FL 33199-2516
Phone
(305) 348-1195
NPI assigned
Dec 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9270405 FL Primary
Family Nurse Practitioner 363LF0000X 9270405 FL

Addresses

Primary practice location

11200 SW 8TH St
Miami, FL 33199-2516

Mailing address

1033 NW 124TH Ave
Pembroke Pines, FL 33026-4320
Phone (754) 244-4393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20171122000602 FL Practitioner - Nurse Practitioner 9234496571 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Health Trust of Miami Dade County FloridaGroup PAC ID 8628981925, shared by 12 NPIs, 56 clinicians

Practice addresses (Care Compare)

15055 NW 27 Ave
Opa Locka, FL 33054-3365
Phone (786) 466-2800

1695 Nw9Th Ave
Miami, FL 33136-1409
Phone (305) 355-8234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
9270405FLMDFamily Nurse Practitioner
APRN9270405FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida Current Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 23, 2019 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 23, 2019 Accepting new patients
Sunrise Detoxification Center, LLC CurrentSince May 4, 2023 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Mar 23, 2019 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Dec 26, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1695 NW 9th Ave
Miami, FL 33136
Phone (305) 355-7147

20201 NW 37th Ave
Opa Locka, FL 33056
Phone (786) 466-2700

15055 NW 27th Ave
Opa Locka, FL 33054
Phone (786) 466-2701

Organizations & group practices 6

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": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1639414337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 NW 124TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264320",
            "telephone_number": "754-244-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331992516",
            "telephone_number": "305-348-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "TAMALA",
        "credential": "MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9270405",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9270405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.