Sam Russo, N.D., LAC, RMSK

Primary specialty

NaturopathTaxonomy code 175F00000X

License

099-0000131 Issued in VT

Practice address

321 Main St Ste B
Winooski, VT 05404-1380

Phone

(802) 636-4133

Fax

(833) 464-3117

NPI assigned

Mar 13, 2007

Last updated

May 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/27613/brand/1/csg/1/fhir/r4
• Direct secure messaging: sam.russo.1@27613.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Winooski Integrative Medicine PC

  • Multi-Specialty Clinic/Center
  • Winooski, VT
  • NPI 1619694478

  Acupuncturist

  NPD Authorized official
• JMS, PLC

  dba Vermont Naturopathic Clinic

  • Naturopath
  • South Burlington, VT
  • NPI 1811205503

  Acupuncturist

  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1891828398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MAIN ST STE B",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041380",
            "telephone_number": "802-636-4133",
            "fax_number": "833-464-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MAIN ST STE B",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041380",
            "telephone_number": "802-636-4133",
            "fax_number": "833-464-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "N.D., LAC, RMSK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VT",
            "license": "091-0000176",
            "primary": false
        },
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "VT",
            "license": "099-0000131",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VT",
            "license": "099-0000131",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "VT",
            "license": "099-0000131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015129",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sam.russo.1@27613.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messages",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "321 Main St Ste B",
            "city": "Winooski",
            "state": "VT",
            "country_code": "US",
            "postal_code": "054041380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allison Pratt, PHARMD
• Professional Nurses Service, Inc.
• Andrea Reynolds, MA, LCMHC, LADC
• Julianne Riva, RD, CD
• Susan Romeo, RD
• Linda Ann Ryan, LADC
• Kelly Anne Rybicki, D.C.
• Frederick Rydz, M.D.
• Veronica Ann Salber, LMT, HHP
• Isabella Sances

• Naturopath in Winooski, VT
• Providers in Winooski, VT by specialty
• Naturopath in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.