Individual provider Active NPI

Russell Glenn Steves, M.ED., PT, ATC

  • Specialist
  • Princeton, NJ
National Provider Identifier
1699797035
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
40QA00378200 Issued in NJ
Practice address
Faculty Road Caldwell Fieldhouse
Princeton University
Princeton, NJ 08544-0001
Phone
(609) 258-3527
Fax
(609) 258-7045
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 40QA00378200 NJ Primary

Addresses

Primary practice location

Faculty Road Caldwell Fieldhouse
Princeton University
Princeton, NJ 08544-0001

Mailing address

15 University PL
Apt 1-N
Princeton, NJ 08540-5154
Phone (609) 430-0376

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
40QA00378200NJMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699797035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 UNIVERSITY PL",
            "address_2": "APT 1-N",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405154",
            "telephone_number": "609-430-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FACULTY ROAD CALDWELL FIELDHOUSE",
            "address_2": "PRINCETON UNIVERSITY",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085440001",
            "telephone_number": "609-258-3527",
            "fax_number": "609-258-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVES",
        "first_name": "RUSSELL",
        "middle_name": "GLENN",
        "name_prefix": "Mr.",
        "credential": "M.ED., PT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "40QA00378200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.