Jessika Lynn Russell

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A5651 Issued in NC

Practice address

1199 Hayes Forest Dr
Winston Salem, NC 27106-3377

Phone

(336) 337-5113

NPI assigned

May 5, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1932782166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9923 REYNOLDA RD",
            "city": "TOBACCOVILLE",
            "state": "NC",
            "postal_code": "270509729",
            "telephone_number": "336-337-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 HAYES FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063377",
            "telephone_number": "336-337-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JESSIKA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A5651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Anne Rusk, PA-C
• Courtney L Russ-Friedman, FNP-BC
• Tiffany Russ, LPN
• Bradly Kalb Russell, DDS
• Jamie Lynn Russell, NURSE PRACTITIONER
• Judith Anita Russell
• Kathryn Russell, CRNA
• Kenneth R Russell, D.D.S.
• Lauren Kennedy Russell, D.D.S.
• Lavonne Lenair Russell, LCASA

• Physical Therapy Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.