Taylor Renee Russell

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201054 Issued in OK

Practice address

1202 W Cherokee St Ste E
Wagoner, OK 74467-4629

Phone

(918) 485-1877

NPI assigned

Mar 26, 2021

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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

University of Oklahoma College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wagoner Hospital AuthorityGroup PAC ID 0042217531, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wagoner Community Hospital Hospital, Wagoner, OK, CCN 370166

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: taylor.russell.2@14254.direct.athenahealth.com

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.

• Wagoner Hospital Authority

  • General Acute Care Hospital
  • Wagoner, OK
  • NPI 1386611580
  Medicare reassignment Care Compare group NPD
• Wagoner Hospital Authority

  • Rural Health Clinic/Center
  • Wagoner, OK
  • NPI 1366674772
  NPD

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

• Wagoner Hospital Authority

  • General Acute Care Hospital
  • Wagoner, OK
  • NPI 1386611580
  Care Compare affiliation
• Wagoner Hospital Authority

  • Clinic/Center
  • Muskogee, OK
  • NPI 1568808988

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1881271864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W CHEROKEE ST STE E",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674629",
            "telephone_number": "918-485-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W CHEROKEE ST STE E",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674629",
            "telephone_number": "918-485-1877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "TAYLOR",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "201054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200979620A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chriss B Roberts, D.O.
• Robin Rodriguez-Higginbottom, M.S.,CCC-SLP
• Rogers Drug Company Inc
• Selma Lea Rogers, M.S. CCC-SLP
• Cruz Rondon
• Shalini Sangal, MD
• Ashley Nicole Sartin
• Lindsey Sarver, CHES
• Chloe Mae Schilling
• Kamilah Scroggins

• Family Nurse Practitioner in Wagoner, OK
• Providers in Wagoner, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.