Active NPI
Donna Reves Russell, NNP
- Neonatal Nurse Practitioner
- Roanoke, VA
National Provider Identifier
1780808907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 0001116283
- Practice address
- 101 Elm Ave SE
Carilion Roanoke Community - Nicu, 6TH and 9TH Floor
Roanoke, VA 24013-2222 - Phone
- (540) 985-8051
- Fax
- (540) 985-8005
- NPI assigned
- Apr 11, 2007
- 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 |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 0001116283 | VA | Primary |
Addresses
Primary practice location
101 Elm Ave SE
Carilion Roanoke Community - Nicu, 6TH and 9TH Floor
Roanoke, VA 24013-2222
Mailing address
1701 Blair Rd SW
Roanoke, VA 24015-3605
Phone (540) 342-7942
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | NONE |
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 |
|---|---|---|---|
| 0001116283 | VA | MD | Neonatal Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780808907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 BLAIR RD SW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240153605",
"telephone_number": "540-342-7942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 ELM AVE SE",
"address_2": "CARILION ROANOKE COMMUNITY - NICU, 6TH AND 9TH FLOOR",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240132222",
"telephone_number": "540-985-8051",
"fax_number": "540-985-8005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "DONNA",
"middle_name": "REVES",
"name_prefix": "Mrs.",
"credential": "NNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "VA",
"license": "0001116283",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "NONE",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.