Individual provider Active NPI

Russell Todd Huffman, RN, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1851776835
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201606694NP-PP Issued in OR
Practice address
1601 E 4TH Plain Blvd
BLDG 17 Ste B222
Vancouver, WA 98661-3753
Phone
(360) 397-8484
Fax
(360) 397-8494
NPI assigned
Jul 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201606694NP-PP OR Primary

Addresses

Primary practice location

1601 E 4TH Plain Blvd
BLDG 17 Ste B222
Vancouver, WA 98661-3753

Mailing address

2485 12TH St SE
Salem, OR 97302-2151
Phone (503) 363-8047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20171020001158 OR Practitioner - Nurse Practitioner 0941576854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

5100 River Rd N
Keizer, OR 97303-5371
Phone (503) 393-2533

665 Winter St SE
Salem, OR 97301-3934
Phone (503) 561-5200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201606694NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Jan 1, 2020 Accepting new patients
Salem Health CurrentSince Jan 1, 2020 Accepting new patients

Locations

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

2485 12th St SE
Salem, OR 97302
Phone (503) 363-8047

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1851776835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 12TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022151",
            "telephone_number": "503-363-8047",
            "fax_number": "503-363-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 4TH PLAIN BLVD",
            "address_2": "BLDG 17 STE B222",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613753",
            "telephone_number": "360-397-8484",
            "fax_number": "360-397-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFMAN",
        "first_name": "RUSSELL",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "RN, ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-20",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201606694NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.