Individual provider Active NPI

Claire Russotto, MA, CF-SLP

  • Speech-Language Pathologist
  • Saint Charles, MO
National Provider Identifier
1720819030
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2024030426 Issued in MO
Practice address
1220 Harvest Ridge Dr
Saint Charles, MO 63303-5972
Phone
(636) 851-5100
NPI assigned
Aug 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2024030426 MO Primary

Addresses

Primary practice location

1220 Harvest Ridge Dr
Saint Charles, MO 63303-5972

Mailing address

1220 Harvest Ridge Dr
Saint Charles, MO 63303-5972
Phone (636) 851-5100

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2024030426MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1720819030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 HARVEST RIDGE DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035972",
            "telephone_number": "636-851-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 HARVEST RIDGE DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035972",
            "telephone_number": "636-851-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSOTTO",
        "first_name": "CLAIRE",
        "credential": "MA, CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2024030426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.