Active NPI
Santo A Russo, OT
- Occupational Therapist
- Belmont, NC
National Provider Identifier
1730496159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2315
- Practice address
- 275 Beatty Dr
Belmont, NC 28012-2715 - Phone
- (704) 512-3391
- NPI assigned
- Sep 7, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2315 | NC | Primary |
Addresses
Primary practice location
275 Beatty Dr
Belmont, NC 28012-2715
Mailing address
1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone (704) 355-4645
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2315 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283817600000",
"number": "1730496159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035814",
"telephone_number": "704-355-4645",
"fax_number": "704-355-4231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 BEATTY DR",
"city": "BELMONT",
"state": "NC",
"postal_code": "280122715",
"telephone_number": "704-512-3391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "SANTO",
"middle_name": "A",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-07",
"last_updated": "2010-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "2315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belmont, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.