Russell Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

RUSSELL NUTRITION LLC

Practice address

1000 Johnson Ferry Rd Ste D125
Marietta, GA 30068-2113

Phone

(404) 314-4014

NPI assigned

Oct 16, 2024

Organization subpart

No

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

Authorized official

Name

Caitlin S Russell, MS, RDNPI 1104173061

Title

Manager

Phone

(404) 314-4014

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Caitlin Russell, MS, RD, LD

  • Registered Dietitian
  • Marietta, GA
  • NPI 1104173061

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1689494296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6275 OLD HICKORY PT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283618",
            "telephone_number": "404-314-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD STE D125",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682113",
            "telephone_number": "404-314-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-314-4014",
        "authorized_official_credential": "MS, RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrica W Rumph, CRNP, FNP-C
• Stevye Rupp, RBT
• Barry Robert Rush, M.D.
• Keonna Rushin
• Michael Ruskin
• Barbara T Russell, LPC
• Brittane Russell, ED.S, BCBA
• Bryan S Russell, DPM FACFAS
• Caitlin Russell, MS, RD, LD
• Cynthia Russell, LCSW

• Registered Dietitian in Marietta, GA
• Providers in Marietta, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.