Active NPI
Robb Russell
- Physical Therapist
- Salida, CO
National Provider Identifier
1821474198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL.0008074
- Practice address
- 550 W 16TH Street
Salida, CO 81201 - Phone
- (719) 539-9080
- Fax
- (719) 539-6122
- NPI assigned
- Aug 10, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTL.0008074 | CO | Primary |
Addresses
Primary practice location
550 W 16TH Street
Salida, CO 81201
Mailing address
550 W 16TH Street
Salida, CO 81201
Phone (719) 539-9080
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0008074 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439164800000",
"number": "1821474198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 W 16TH STREET",
"city": "SALIDA",
"state": "CO",
"postal_code": "81201",
"telephone_number": "719-539-9080",
"fax_number": "719-539-6122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 W 16TH STREET",
"city": "SALIDA",
"state": "CO",
"postal_code": "81201",
"telephone_number": "719-539-9080",
"fax_number": "719-539-6122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "ROBB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-10",
"last_updated": "2015-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL.0008074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salida, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.