Mark Brennan Russo, PT, DPT

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1178901 Issued in TX

Practice address

751 Hebron Pkwy Ste 160
Lewisville, TX 75057-5120

Phone

(972) 315-1234

NPI assigned

Jul 9, 2010

Last updated

Apr 9, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ampic Rehab, PLLC

  dba Ampic Physical Therapy

  • Physical Therapist
  • Plano, TX
  • NPI 1699059394
  NPD (past) Authorized official
• Performance Orthopaedics & Sports Medicine, P.a.

  • Orthopaedic Surgery Physician
  • Frisco, TX
  • NPI 1962663682
  NPD (past)
• Synergy Chiropractic and Health Center PA

  • Chiropractor
  • Naples, FL
  • NPI 1396002952
  NPD (past)

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1669784419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250264",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750250264",
            "telephone_number": "972-315-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 HEBRON PKWY STE 160",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750575120",
            "telephone_number": "972-315-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "MARK",
        "middle_name": "BRENNAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-09",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "1178901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RRR Hyperbarics 4, LLC (R3 Wound Care and Hyperbarics)
• Cathy Faye Ruelas, PT
• Adriana Ruiz, NURSE PRACTITIONER
• Russell V Stover, DDS, PC
• Jennifer Ragan Russell, D.O.
• Kaely Rutten
• Rxmed Pharmacy PLLC (Rxmed Pharmacy)
• Bethany Rydeen
• Huma Saeed, RPH
• Simon Gabriel Safir

• Home Health Agency in Lewisville, TX
• Providers in Lewisville, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.