Active NPI
Anna M Russell, DO
- Psychiatry Physician
- San Antonio, TX
National Provider Identifier
1770105413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0102206966
- Practice address
- 3100 Schofield Rd BLDG 1179
San Antonio, TX 78234-7577 - Phone
- (210) 808-1859
- NPI assigned
- May 16, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0102206966 | VA | Primary |
Addresses
Primary practice location
3100 Schofield Rd BLDG 1179
San Antonio, TX 78234-7577
Mailing address
3100 Schofield Rd BLDG 1179
San Antonio, TX 78234-7577
Phone (210) 808-1859
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102206966 | VA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1770105413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SCHOFIELD RD BLDG 1179",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782347577",
"telephone_number": "210-808-1859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 SCHOFIELD RD BLDG 1179",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782347577",
"telephone_number": "210-808-1859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "ANNA",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-16",
"last_updated": "2024-07-08",
"certification_date": "2024-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0102206966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.