Individual provider Active NPI

Christine Elaine Russell, NP

  • Gerontology Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1790322097
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024178539 Issued in VA
Practice address
301 Riverview Ave Ste 400
Norfolk, VA 23510-1065
Phone
(757) 622-5325
Fax
(757) 625-6743
NPI assigned
Dec 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024178539 VA Primary

Addresses

Primary practice location

301 Riverview Ave Ste 400
Norfolk, VA 23510-1065

Mailing address

14 W Riverpoint Dr
Hampton, VA 23669-1072
Phone (757) 262-9405

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201019000305 VA Practitioner - Nurse Practitioner 5294155933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Atlantic Post Acute and Long Term Care PLLCGroup PAC ID 0648530782, 142 clinicians

Practice addresses (Care Compare)

6160 Kempsville Cir
Suite 325a
Norfolk, VA 23502-3933
Phone (757) 354-2885

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Post Acute & Long Term Care PLLC Gerontology CurrentSince Nov 16, 2021 Accepting new patients
SE Virginia Value Based Care, LLC CurrentSince Aug 1, 2023 Accepting new patients
Integrated Medical Services PLC Past Accepting new patients

Locations

6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885

1309 Kempsville Rd
Norfolk, VA 23502
Phone (757) 446-5794

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1790322097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 W RIVERPOINT DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236691072",
            "telephone_number": "757-262-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 400",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101065",
            "telephone_number": "757-622-5325",
            "fax_number": "757-625-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHRISTINE",
        "middle_name": "ELAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024178539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.