Active NPI
Diana Kay Russell, SLP
- Speech-Language Pathologist
- Rochester, NY
National Provider Identifier
1881989028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 012359-1
- Practice address
- 198 Mill Hollow Xing
Rochester, NY 14626-1084 - Phone
- (585) 225-4552
- NPI assigned
- Jun 16, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 012359-1 | NY | Primary |
Addresses
Primary practice location
198 Mill Hollow Xing
Rochester, NY 14626-1084
Mailing address
198 Mill Hollow Xing
Rochester, NY 14626-1084
Phone (585) 225-4552
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12014358 | Other | NY | NYS LICENSE NUMBER012359-1 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012359-1 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308182400000",
"number": "1881989028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "198 MILL HOLLOW XING",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146261084",
"telephone_number": "585-225-4552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 MILL HOLLOW XING",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146261084",
"telephone_number": "585-225-4552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "DIANA",
"middle_name": "KAY",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-16",
"last_updated": "2011-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "012359-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS LICENSE NUMBER012359-1",
"identifier": "12014358",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.