Stephanie N Russell, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA11080 Issued in OH

Practice address

3572 Dayton Xenia Rd
Beavercreek, OH 45432-2886

Phone

(937) 427-4600

NPI assigned

Mar 22, 2010

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

Enrolled in OH

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

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 and National Provider Directory roles.

• Dermatology & Skin Care Associates

  • Dermatology Physician
  • West Chester, OH
  • NPI 1033444997
  Medicare reassignment NPD

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1891019758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 MEADOWS DR",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450668649",
            "telephone_number": "937-286-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3572 DAYTON XENIA RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322886",
            "telephone_number": "937-427-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "STEPHANIE",
        "middle_name": "N",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-22",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA11080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret H. Roy, M.S., LPCC, IMFT
• Kathleen Simms Rudolf, O. D.
• Sandra L Rue, RN
• Chloe Ruggiero
• Mary Runnoe, MS, LPCC
• Shalini Aggarwal Ryan, DO
• Sabra Midwest Operations X, LLC
• Chelsea Iles Sadek, DO
• Amaal Sabri Salhieh, MD
• Jenna Bullock Saliba, MSW, LISW-S

• Family Nurse Practitioner in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.