Sabrina Russom, NP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704295757 Issued in MI

Practice address

6507 Town Center Dr
Clarkston, MI 48346-4826

Phone

(248) 620-4000

NPI assigned

Dec 6, 2021

Sex

Female

Sole proprietor

Yes

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

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Oakland Univ, William Beaumont School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Flushing Urgent Care PLCGroup PAC ID 2961653803, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: srussom1846797@direct.trinity-health.org

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.

• Flushing Urgent Care PLC

  • Urgent Care Clinic/Center
  • Flushing, MI
  • NPI 1780930016

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Michigan Kidney Consultants, P.C.

  • Nephrology Physician
  • Sterling Heights, MI
  • NPI 1831130723

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1831857903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 TOWN CENTER DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 TOWN CENTER DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464826",
            "telephone_number": "248-620-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSOM",
        "first_name": "SABRINA",
        "credential": "NP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704295757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivianna Rubles, LLPC
• Leah Marie Ruddock
• Jeremy Rudkin, D.C.
• Kelsey Ann Ruffin, BCBA
• Karen Marie Rusniak, PHD
• Katie Lyn Rutkowski, P.A.-C
• Thomas Joseph Rydzon, DDS
• David P Sakstrup, RPH
• Salta of Clarkston, PLLC
• James E Sampson, LMSW

• Nurse Practitioner in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.

Verify at the official NPI Registry.