Russo Rehabilitation, LLC

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

Legal business name

RUSSO REHABILITATION, LLC

Practice address

505 Louvois St
Mandeville, LA 70448-5468

Phone

(678) 462-2923

Fax

(866) 753-4652

NPI assigned

Sep 30, 2011

Organization subpart

No

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

Authorized official

Name

Kelly Russo Stone, OTR/L

Title

Ceo; Owner; Occupational Therapist

Phone

(678) 462-2923

Specialties & licenses 5

Addresses

Other identifiers 1

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1902180573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 LOUVOIS ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704485468",
            "telephone_number": "678-462-2923",
            "fax_number": "866-753-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 LOUVOIS ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704485468",
            "telephone_number": "678-462-2923",
            "fax_number": "866-753-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSO REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "RUSSO",
        "authorized_official_title_or_position": "CEO; OWNER; OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "678-462-2923",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XE0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2450514",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Lynne Ruegsegger, DDS
• Kylie Chabreck Rumsey, RN
• Taylor Elizabeth Ruppert, DC
• Janice E. Rushing, BCSAC
• Lugene Russ Naparalla, M.C.D.
• Samantha Buras Russo, PMHNP-BC
• Ryan a Hildebrand DC, PCC
• Karen Dyer Saacks, DDS
• Danielle Sabathe, DPT
• John H Sabatier, M.D.

• Neurorehabilitation Occupational Therapist in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Neurorehabilitation Occupational Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.