Alexandria Russell

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL011710 Issued in PA

Practice address

12 S Letitia St Apt 204
Philadelphia, PA 19106-3033

Phone

(917) 579-6305

NPI assigned

Dec 2, 2013

Last updated

Dec 2, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Wynter Wellness Group LLC

  • Speech-Language Pathologist
  • Philadelphia, PA
  • NPI 1396403408
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385942400000",
    "number": "1669803664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 S LETITIA ST APT 204",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S LETITIA ST APT 204",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063033",
            "telephone_number": "917-579-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ALEXANDRIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL011710",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "07161",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soby A Russal, O.D.
• Kathryn E Russel, RDN
• Russell Byers Charter School
• Anila Yasmine Russell-Hall
• Akim Russell, M.ED
• Ayanna Russell, BEHAVIOR TECHNICIAN
• Christopher Russell
• Darleen Russell
• Eddie Russell, CRNA
• Heather Flynn Russell, PHD

• Speech-Language Pathologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.