Active NPI
Julie M Russell, CPTA
- Physical Therapy Assistant
- Great Bend, KS
National Provider Identifier
1669118527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 14-01047
- Practice address
- 4801 10TH St
Great Bend, KS 67530-3252 - Phone
- (620) 792-7868
- NPI assigned
- May 12, 2022
- Last updated
- May 12, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 14-01047 | KS | Primary |
Addresses
Primary practice location
4801 10TH St
Great Bend, KS 67530-3252
Mailing address
2912 R Rd
Haviland, KS 67059-4718
Phone (620) 770-0490
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | therapy@ptkansas.com |
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 |
|---|---|---|---|
| 14-01047 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652313600000",
"number": "1669118527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2912 R RD",
"city": "HAVILAND",
"state": "KS",
"postal_code": "670594718",
"telephone_number": "620-770-0490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 10TH ST",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675303252",
"telephone_number": "620-792-7868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "JULIE",
"middle_name": "M",
"credential": "CPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-12",
"last_updated": "2022-05-12",
"certification_date": "2022-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-01047",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "therapy@ptkansas.com",
"affiliation": "N",
"address_1": "4801 10th St",
"city": "Great Bend",
"state": "KS",
"country_code": "US",
"postal_code": "675303252",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Great Bend, KS
- Kiersten Rogers, LMSW
- Justus Nicole Romine
- Rosenberg Dentistry: Joe Rosenberg DDS. PA
- Rosewood Services, Inc.
- Cody James Ruble, FIREFIGHTER/MEDIC
- Leanne K Russell, LPC
- Saint-Mark Enterprises 1196 LLC (The Medicine Shoppe Pharmacy)
- Karina Carlos Salazar-Desantores, PT
- Beverley Renee Sammons, APRN, WHNP
- Flor Sanchez, CHW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.