Jodi Lynn Russell, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT004416 Issued in PA

Practice address

1350 Broadcasting Rd
Suite 201
Wyomissing, PA 19610-3229

Phone

(610) 685-9600

Fax

(610) 685-6700

NPI assigned

Sep 22, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1780967166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BROADCASTING RD",
            "address_2": "SUITE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103229",
            "telephone_number": "610-685-9600",
            "fax_number": "610-685-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BROADCASTING RD",
            "address_2": "SUITE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103229",
            "telephone_number": "610-685-9600",
            "fax_number": "610-685-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT004416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert I Rudolph, M.D.
• Jennifer Ruiz
• Daniel J Runkle
• Teresa Runkle, R.D.
• Jessica A Rupp, M.A.
• Michael Bernard Russo, M.D.
• Megan Elizabeth Rutherford, M.S. CCC-SLP
• Marie Cornelia Ryan, LSW
• Mary Ryan, OT
• S. M. Lago Internal Medicine Associates, P.C.

• Athletic Trainer in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.