Individual provider Active NPI

Christine M Russell, PT

  • Physical Therapist
  • North East, PA
National Provider Identifier
1891774790
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-015047-L Issued in PA
Practice address
10680 W Main Rd
North East, PA 16428-2226
Phone
(814) 725-4808
Fax
(814) 725-5002
NPI assigned
Jan 10, 2006
Last updated
Jan 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-015047-L PA Primary

Addresses

Primary practice location

10680 W Main Rd
North East, PA 16428-2226

Mailing address

404 Baker Ave
Erie, PA 16511-2304
Phone (814) 824-4346

Other names 1

  • Christine Russell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241215000095 PA Practitioner - Physical Therapist in Private Practice 7618928722 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-015047-LPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Novacare Outpatient Rehabilitation East Inc CurrentSince Oct 7, 2024 Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. Physical Therapist Current Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. CurrentSince Oct 7, 2024 Accepting new patients
Cambridge Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

2850 E 38th St
Erie, PA 16510
Phone (814) 899-1023

352 Railroad St
Ligonier, PA 15658
Phone (724) 238-3301

1012 Water St
Meadville, PA 16335
Phone (814) 333-2001

10680 W Main Rd
North East, PA 16428
Phone (814) 490-6456

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1891774790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 BAKER AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165112304",
            "telephone_number": "814-824-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10680 W MAIN RD",
            "city": "NORTH EAST",
            "state": "PA",
            "postal_code": "164282226",
            "telephone_number": "814-725-4808",
            "fax_number": "814-725-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT-015047-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "RUSSELL",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North East, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.