Russell House

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

MHL-076-108 Issued in NC

Legal business name

RUSSELL HOUSE

Practice address

1691 Old Buffalo Ford Rd
Asheboro, NC 27205-7893

Phone

(336) 672-0169

Fax

(336) 672-0169

NPI assigned

Apr 25, 2012

Organization subpart

No

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

Authorized official

Name

Maynard Russell

Title

Director

Phone

(336) 672-0169

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689932865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 OLD BUFFALO FORD RD",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272057893",
            "telephone_number": "336-672-0169",
            "fax_number": "336-672-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 OLD BUFFALO FORD RD",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272057893",
            "telephone_number": "336-672-0169",
            "fax_number": "336-672-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "MAYNARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-672-0169"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-076-108",
            "primary": true
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NC",
            "license": "MHL-076-108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Todd Rothfuss, PA
• Sarah Troutman Routh, NP
• Travis Lee Routh, PT
• Karen J. Rudd, LCC
• Edgar Ruiz Aragon, DMD
• Edward Saguier, P.A.
• Milota Ruth Salay, LPC, NCC
• Addison Marie Salisbury
• Leandra Jenene Salley, MSW, LCAS
• Salyer Chiropractic Clinic P.a.

• Adult Care Home Facility in Asheboro, NC
• Providers in Asheboro, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.