Alexandra Denise Russell, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2010031805 Issued in MO

Practice address

225 Physicians Park
Suite 101
Poplar Bluff, MO 63901-3956

Phone

(573) 778-9348

Fax

(573) 686-4870

NPI assigned

Apr 26, 2011

Last updated

Aug 6, 2013By the provider in NPPES

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

Other names 1

• Alexandra Denise Coe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1922399849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 N WESTWOOD BLVD",
            "address_2": "SUITE 17",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012346",
            "telephone_number": "573-778-9348",
            "fax_number": "573-686-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK",
            "address_2": "SUITE 101",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013956",
            "telephone_number": "573-778-9348",
            "fax_number": "573-686-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ALEXANDRA",
        "middle_name": "DENISE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2010031805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "COE",
            "middle_name": "DENISE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Juan Carlos Ruben Ruiz Diaz, M.D.
• Rural-Metro Mid-South LP
• Scott D Rush
• Rushin Chiropractic PC (Rushin Chiropractic Center)
• Jack Douglas Rushin, D.C.
• Debra G Russell, FNP
• Shilo Russell
• Victoria Russell
• Jessica Elizabeth Russom
• Wyatt Russom

• Physical Therapist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.