Lisa Dawn Russell, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.012482 Issued in IL

Practice address

1343 County Road 1450 E
Carmi, IL 62821-5205

Phone

(618) 382-2103

NPI assigned

Sep 13, 2013

Last updated

Feb 29, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1730514316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18033 COUNTY ROAD 500 E",
            "city": "DAHLGREN",
            "state": "IL",
            "postal_code": "628284294",
            "telephone_number": "618-648-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1343 COUNTY ROAD 1450 E",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "628215205",
            "telephone_number": "618-382-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LISA",
        "middle_name": "DAWN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28101863A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.012482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oma Snedecor Rice, LCSW
• Bennett Richter, MS, LAT, ATC
• Cristina C Riley
• Timothy Wayne Roser, DMD
• Katie Beth Rowland, OTR/L
• Sarah Nicole Russell, OTR
• Taylor Rutledge, COTA/L
• Carole Renee Sandusky, LPC
• Zahid Saqib, MD
• Chanda Fern Sauls, APN

• Family Nurse Practitioner in Carmi, IL
• Providers in Carmi, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.