Kristin B Russo, PT, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10259024 Issued in WI

Practice address

5070 W Rawson Ave
Franklin, WI 53132-9448

Phone

(414) 377-9765

NPI assigned

Jul 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• KSR Performance Physical Therapy LLC

  • Physical Therapist
  • Franklin, WI
  • NPI 1083222376
  Medicare reassignment NPD
• Sports Physical Therapy & Rehab Specialists, S.C.

  • Physical Therapist
  • Kenosha, WI
  • NPI 1326150624
  NPD (past)
• Sports Physical Therapy & Rehabilitation Specialists S.C.

  • Clinic/Center
  • Mukwonago, WI
  • NPI 1174187975

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1730118423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5070 W RAWSON AVE",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329448",
            "telephone_number": "414-377-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5070 W RAWSON AVE",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329448",
            "telephone_number": "414-377-9765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10222 74th St",
            "address_2": "Suite 211",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531426810",
            "country_code": "US",
            "telephone_number": "262-925-5020",
            "fax_number": "262-925-5021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "KRISTIN",
        "middle_name": "B",
        "credential": "PT, MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070014170",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10259024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40441700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11454657",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roundys Supermarkets Inc
• Rebecca Rudella, OTR
• Ashlee Mary Ruiz-Reyes
• Anne E Ruiz, LPC
• Andrew Rumler, DPT
• Kim M Rutter, PA-C, R.PH.
• Andreas Rydland, PH.D
• Karisa Saeger
• Safesupply LLC
• Kaytlin Sagan

• Physical Therapist in Franklin, WI
• Providers in Franklin, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.