Danielle Russell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P160280156 Issued in WA

Practice address

1010 Robert Bush Drive West
South Bend, WA 98586

Phone

(360) 875-5543

NPI assigned

Jul 26, 2022

Last updated

Jul 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rehabvisions Therapy Wa, LLC

  dba RehabVisions

  • Physical Therapy Clinic/Center
  • South Bend, WA
  • NPI 1265823694
  NPD

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1871229591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 PENNY LN",
            "city": "RAYMOND",
            "state": "WA",
            "postal_code": "985779002",
            "telephone_number": "360-589-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 ROBERT BUSH DRIVE WEST",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "98586",
            "telephone_number": "360-875-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DANIELLE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160280156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael James Reeves, CRNA
• Rehabvisions Therapy Wa, LLC (RehabVisions)
• Charles Alec Reidinger, CRNA
• Ruby Behavior Consulting, LLC
• Ruby Behavioral Consulting, LLC (Rural Behavioral Connections)
• Ramona Shatraw
• Debra D Slapper, MD
• South Bend School District
• Anne Elizabeth Townsend, L.D.
• Vitality Massage

• Physical Therapy Assistant in South Bend, WA
• Providers in South Bend, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.