Active NPI
Elana Russell, APRN
- Family Nurse Practitioner
- Conway, AR
National Provider Identifier
1831589720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A004254
- Practice address
- 2200 Ada Ave Ste 302
Conway, AR 72034-4985 - Phone
- (501) 932-0352
- Fax
- (501) 932-0354
- NPI assigned
- Jan 29, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0000371 | CO | |
| Family Nurse Practitioner | 363LF0000X | A004254 | AR | Primary |
Addresses
Primary practice location
2200 Ada Ave Ste 302
Conway, AR 72034-4985
Mailing address
2200 Ada Ave Ste 302
Conway, AR 72034-4985
Phone (501) 932-0352
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 214913758 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160829001399 | AR | Practitioner - Nurse Practitioner | 2062726375 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A004254 | AR | MD | Family Nurse Practitioner |
| 0000371 | CO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conway Regional Medical Center Inc | Current | Accepting new patients | |
| Conway Regional Medical Center, Inc. | Current | Accepting new patients | |
| Conway Regional Medical Center Inc | Past | Accepting new patients |
Locations
2200 Ada Ave
Ste 305
Conway, AR 72034
Phone (501) 227-6044
2200 Ada Ave
Ste 302
Conway, AR 72034
Phone (501) 932-0352
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.
-
- Family Medicine Physician
- Conway, AR
- NPI 1043183544
-
- General Acute Care Hospital
- Conway, AR
- NPI 1497770424
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Family Medicine Physician
- Russellville, AR
- NPI 1245729359
Hospital
-
- Rural Health Clinic/Center
- Mayflower, AR
- NPI 1851389605
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Conway Regional Medical Center Inc
Practice addresses (Care Compare)
2200 Ada Ave
Suite 302
Conway, AR 72034-4985
Phone (501) 932-0352
Hospital & facility affiliations
- Conway Regional Medical Center, Inc
- Baptist Health Medical Center- Conway
- St Marys Regional Medical Center
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1831589720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 ADA AVE STE 302",
"city": "CONWAY",
"state": "AR",
"postal_code": "720344985",
"telephone_number": "501-932-0352",
"fax_number": "501-932-0354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 ADA AVE STE 302",
"city": "CONWAY",
"state": "AR",
"postal_code": "720344985",
"telephone_number": "501-932-0352",
"fax_number": "501-932-0354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "ELANA",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-29",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "0000371",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A004254",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "214913758",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.