Mary Theresa Russell, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71002193A Issued in IN

Practice address

3834 S Emerson Ave Ste 100
Indianapolis, IN 46203

Phone

(317) 782-1577

Fax

(317) 780-5549

NPI assigned

Aug 3, 2006

Last updated

Feb 25, 2020By 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 1

Addresses

Other identifiers 1

Other names 1

• Mary Theresa Rojowski Former name

Medicare fee-for-service enrollment

Enrolled in IN, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Altea Medical Indiana PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gary, IN
  • NPI 1992584783
  Medicare reassignment NPD
• Franciscan Physician Network

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1225327984
  Medicare reassignment NPD
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment NPD
• Karen T Shirrell, M.D.

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1922009109
  Medicare reassignment
• Franciscan Physician Network

  dba Franciscan Immediate Care

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1366879009
  NPD
• Franciscan Physician Network

  • Clinic/Center
  • Lafayette, IN
  • NPI 1992543250
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Karen T. Shirrell, MD

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1770914574
  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Arnot Medical Services PLLC

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1427326768
  NPD (past)
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1770590374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3299",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897023299",
            "telephone_number": "775-222-0044",
            "fax_number": "888-700-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3834 S EMERSON AVE STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46203",
            "telephone_number": "317-782-1577",
            "fax_number": "317-780-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71002193A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200492000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ROJOWSKI",
            "middle_name": "THERESA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Jane Russell, AU.D.
• Kaycee Sue Russell
• Kaylee Becca Russell, SLP
• Kernest Russell
• Lindsay Russell, APN
• Meghan Mary Russell
• Michael Russell, MD
• Michelle Lea Russell, RN
• Nathaniel Russell
• Olivia B Russell, LCSW

• Adult Health Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Adult Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.