Active NPI
Angela Landon Russell, PT
- Physical Therapist
- Ocean City, MD
National Provider Identifier
1669798328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18674
- Practice address
- 9830 Harbor Master Blvd
Ocean City, MD 21842-9381 - Phone
- (410) 713-2216
- NPI assigned
- Apr 20, 2010
- 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 Therapist | 225100000X | 18674 | MD | Primary |
Addresses
Primary practice location
9830 Harbor Master Blvd
Ocean City, MD 21842-9381
Mailing address
9830 Harbor Master Blvd
Ocean City, MD 21842-9381
Phone (410) 713-2216
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 435138000 | Medicaid | MD | |
| 216538 | Other | MD | MEDICARE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421193600000",
"number": "1669798328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9830 HARBOR MASTER BLVD",
"city": "OCEAN CITY",
"state": "MD",
"postal_code": "218429381",
"telephone_number": "410-713-2216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9830 HARBOR MASTER BLVD",
"city": "OCEAN CITY",
"state": "MD",
"postal_code": "218429381",
"telephone_number": "410-713-2216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "ANGELA",
"middle_name": "LANDON",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-20",
"last_updated": "2015-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "18674",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "435138000",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "216538",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocean City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.