Active NPI
Diane Russo
- Registered Dietitian
- Anchorage, AK
National Provider Identifier
1780623561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 100
- Practice address
- 4201 Tudor Centre Dr
Suite 320
Anchorage, AK 99508-5904 - Phone
- (907) 729-4955
- NPI assigned
- Jun 6, 2006
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 100 | AK | Primary |
Addresses
Primary practice location
4201 Tudor Centre Dr
Suite 320
Anchorage, AK 99508-5904
Mailing address
1800 E Parks Hwy
Wasilla, AK 99654-7353
Phone (907) 729-6000
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 |
|---|---|---|---|
| 100 | AK | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1780623561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 E PARKS HWY",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547353",
"telephone_number": "907-729-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 TUDOR CENTRE DR",
"address_2": "SUITE 320",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085904",
"telephone_number": "907-729-4955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "DIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AK",
"license": "100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.