Dr. Russell Masterson PA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY4235 Issued in FL

Legal business name

DR. RUSSELL MASTERSON PA

Practice address

878 109TH Ave N
Naples, FL 34108-1814

Phone

(239) 596-8416

NPI assigned

Nov 13, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Russell W Masterson, PHD

Title

Owner

Phone

(239) 596-8416

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1932539939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "878 109TH AVE N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341081814",
            "telephone_number": "239-596-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "878 109TH AVE N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341081814",
            "telephone_number": "239-596-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RUSSELL MASTERSON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-13",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-596-8416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY4235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Naples, FL
• Providers in Naples, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.