Russell Pet M.D. Inc

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

Legal business name

RUSSELL PET M.D. INC

Practice address

4 Hartwell St
Fall River, MA 02721-3019

Phone

(508) 675-0089

Fax

(508) 675-2233

NPI assigned

Apr 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. L Russell Pet, MD

Title

President

Phone

(508) 675-0089

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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.

• L. Russell Pet, M.D.

  • Psychiatry Physician
  • Fall River, MA
  • NPI 1194745257
  Medicare reassignment NPD

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271894400000",
    "number": "1710204391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HARTWELL ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027213019",
            "telephone_number": "508-675-0089",
            "fax_number": "508-675-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HARTWELL ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027213019",
            "telephone_number": "508-675-0089",
            "fax_number": "508-675-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL PET M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-22",
        "last_updated": "2010-04-22",
        "status": "A",
        "authorized_official_last_name": "PET",
        "authorized_official_first_name": "L",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-675-0089",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3154564",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura G Runyan, PA-C
• Alexa R Rupert
• Lindsay Ruschel
• Laura Rusin
• Anne-Maria Russ, M.S.,CCC-SLP
• Kimberly Ann Russell
• Andrea Russo
• Cornelia M Ryan, MSW, LICSW
• Kelley Ryan
• Victoria Ryan, MA

• Child & Adolescent Psychiatry Physician in Fall River, MA
• Providers in Fall River, MA by specialty
• Child & Adolescent Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; 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.