Russell Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

RUSSELL PHYSICAL THERAPY

Practice address

208 E Main St
Oak Grove, LA 71263-2557

Phone

(318) 282-5468

NPI assigned

Nov 26, 2024

Organization subpart

No

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

Authorized official

Name

Dalton Russell, DPTNPI 1891558789

Title

Owner

Phone

(318) 282-5468

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dalton Lee Russell

  • Physical Therapist
  • Monroe, LA
  • NPI 1891558789
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1912723776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 PULLTIGHT RD",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712639187",
            "telephone_number": "318-282-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E MAIN ST",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712632557",
            "telephone_number": "318-282-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "DALTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-282-5468",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Martin Perkins, PHARM.D.
• Mark Anthony Portacci, MD
• Jeremy David Rawls, DC
• Lisa Cox Reardon, M.ED
• Karla Welch Robertson, DDS
• Jeanie Rye, RPH
• Melba B Sandifer, LCSW
• Shama Pulmonary Rehab. Center Inc.
• Shama Pulmonary Rehabilitation Center Inc
• Saidi Sowma, MD

• Physical Therapist in Oak Grove, LA
• Providers in Oak Grove, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.