Christina L Russell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13547 Issued in TX

Practice address

525 Oak Centre Dr Ste 100
San Antonio, TX 78258-3916

Phone

(210) 640-9048

NPI assigned

Feb 11, 2020

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jibrail Kasperkhan, M.D. PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • San Antonio, TX
  • NPI 1215164843
  Medicare reassignment
• South Texas Healthcare Inc

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1700276573
  Medicare reassignment

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1962034694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 OAK CENTRE DR",
            "address_2": "STE 140",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583916",
            "telephone_number": "210-504-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 OAK CENTRE DR STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583916",
            "telephone_number": "210-640-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHRISTINA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE NUMBER",
            "identifier": "T000",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dionne Russell Baker, LPC
• Anna M Russell, DO
• Ashley Rene Russell, CNIM
• Charles Mark Russell, PA
• Charly Ann Russell, BT
• Christina Louise Russell, LPC
• Delisa Duncan Russell, LPC-S
• Douglas Russell, DO
• Edward L. Russell, PA
• Kathryn Russell, PA-C

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.