Samantha C Russell

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-2022-0029 Issued in NM

Practice address

Unm Health Sciences Center Msc09-5030
Albuquerque, NM 87131

Phone

(505) 272-2223

NPI assigned

Apr 22, 2020

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

Enrolled in NM

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Presbyterian Healthcare Services

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• Sun & Moon Psychological Services LLC

  • Psychologist
  • Albuquerque, NM
  • NPI 1760196489
  NPD Authorized official
• Mindbodymom, Inc.

  • Psychologist
  • Flagstaff, AZ
  • NPI 1538029988
  NPD Authorized official
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1780204404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNM HEALTH SCIENCES CENTER MSC09-5030",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNM HEALTH SCIENCES CENTER MSC09-5030",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87131",
            "telephone_number": "505-272-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SAMANTHA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "NM-PSY-2022-0029",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "PSY-2022-0029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Russell
• John Russell
• Julie Russell
• Julie Laine Russell, OTR/L
• Richard Russell
• Sandra R Russell
• Stefanie Russell, S.L.P.
• Troy Russell, PHARMD
• Francesca Michelle Russo-Goforth, DC
• Anella Maria Russo, RN

• Clinical Psychologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.