Shirley Louise Russell, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP 9229120 Issued in FL

Practice address

5915 Normandy Blvd
Jacksonville, FL 32205-6200

Phone

(904) 378-0121

Fax

(904) 378-0122

NPI assigned

Jun 8, 2006

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

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Solantic LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1609822592
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1780625244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8711 PERIMETER PARK BLVD",
            "address_2": "SUITE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166388",
            "telephone_number": "904-223-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5915 NORMANDY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056200",
            "telephone_number": "904-378-0121",
            "fax_number": "904-378-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SHIRLEY",
        "middle_name": "LOUISE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9229120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Russell
• Michael James Russell, LMHC
• Millie Dean Russell, D.D.S.
• Ron Khai Acio Russell
• Samantha L Russell, MOT
• William Russell, DMD
• Ginamarie Russo, LMFT, LMHC
• Louis Russo, M.D.
• Charles A Rust, M.D.
• Arles L Rustia, CRNA

• Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.