Individual provider Active NPI

Sarah Louise Russo

  • Physical Rehabilitation Occupational Therapist
  • Palm Harbor, FL
National Provider Identifier
1790280071
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
OT13576 Issued in FL
Practice address
3981 Wellington Pkwy
Palm Harbor, FL 34685-1172
Phone
(813) 402-0689
NPI assigned
Mar 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X OT13576 FL Primary

Addresses

Primary practice location

3981 Wellington Pkwy
Palm Harbor, FL 34685-1172

Mailing address

3213 Brookeview CT
Naples, FL 34120-4470
Phone (239) 298-3045

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

LicenseStateTypeSpecialty
OT13576FLMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1790280071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 BROOKEVIEW CT",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341204470",
            "telephone_number": "239-298-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3981 WELLINGTON PKWY",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346851172",
            "telephone_number": "813-402-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "SARAH",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "FL",
            "license": "OT13576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.