Active NPI
Kionte Russell, DPT
- Physical Therapist
- Houston, TX
National Provider Identifier
1770240475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1355001
- Practice address
- 2000 Holly Hall St
Houston, TX 77054-4032 - Phone
- (713) 799-9031
- NPI assigned
- Nov 17, 2021
- Last updated
- Nov 17, 2021
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1355001 | TX | Primary |
Addresses
Primary practice location
2000 Holly Hall St
Houston, TX 77054-4032
Mailing address
13130 Clifton Hill LN
Houston, TX 77044-2907
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 |
|---|---|---|---|
| 1355001 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1770240475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13130 CLIFTON HILL LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770442907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 HOLLY HALL ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770544032",
"telephone_number": "713-799-9031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "KIONTE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-17",
"last_updated": "2021-11-17",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1355001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.