Peni Jean Russell

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

589871 Issued in TX

Practice address

283 County Road 264
Nacogdoches, TX 75965-0530

Phone

(936) 564-8735

Fax

(936) 564-5033

NPI assigned

Oct 20, 2011

Last updated

Oct 20, 2011By the provider in NPPES

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 TX

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

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrative Emergency Services Physician Group-Houston PLLCGroup PAC ID 7113258500, 212 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Lukes Health Memorial San Augustine Hospital, San Augustine, TX, CCN 670783

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Integrative Emergency Services Physician Group-Houston PLLC

  dba IES Houston

  • Emergency Medicine Physician
  • Pasadena, TX
  • NPI 1801458708
  Medicare reassignment Care Compare group NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019

  Family

  Medicare reassignment NPD
• Bonita Creek Emergency Services PLLC

  • Emergency Medicine Physician
  • Nacogdoches, TX
  • NPI 1902555485
  Medicare reassignment NPD
• Ess of Nacogdoches LLC

  • Emergency Medicine Physician
  • Nacogdoches, TX
  • NPI 1780139956
  Medicare reassignment NPD
• Texas Em-I Medical Services PA

  • Emergency Medicine Physician
  • Angleton, TX
  • NPI 1437334414
  Medicare reassignment NPD
• Texas Em-I Medical Services PA

  • Emergency Medicine Physician
  • McKinney, TX
  • NPI 1801388848
  NPD
• Camino Real Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Livingston, TX
  • NPI 1992871966
  NPD (past)
• Texas Emergency Room Services PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1992843387
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Medical Center San Augustine

  dba CHI St. Luke's Health Memorial San Augustine

  • Rural Acute Care Hospital
  • San Augustine, TX
  • NPI 1578547345
  Care Compare affiliation

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1871878835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 COUNTY ROAD 264",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75965",
            "telephone_number": "936-564-8735",
            "fax_number": "936-564-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 COUNTY ROAD 264",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759650530",
            "telephone_number": "936-564-8735",
            "fax_number": "936-564-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "PENI JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "589871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salena Rothenberger
• RRK Health Solution
• Kira Rubin, ATC
• Don Paul Rudasill, O.D.
• Melanie G Rushing, O.D.
• Bonnie Bass Ryan, PA-C
• Irma M Sainz, MD
• Gerardo Saldana Jr., O.D.
• Sannya Salim, PHARMD
• Samaritan Counseling Center of East TX, Inc

• Family Nurse Practitioner in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.