Kristine Kavanagh Russo

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2023 Issued in AL

Practice address

245 Cahaba Valley Pkwy
Suite 200
Pelham, AL 35124-2216

Phone

(205) 942-6820

Fax

(205) 942-5884

NPI assigned

Apr 9, 2009

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

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1962645713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CAHABA VALLEY PKWY STE 200",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242217",
            "telephone_number": "205-942-6820",
            "fax_number": "205-942-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CAHABA VALLEY PKWY",
            "address_2": "SUITE 200",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242216",
            "telephone_number": "205-942-6820",
            "fax_number": "205-942-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "KRISTINE",
        "middle_name": "KAVANAGH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "2023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davis Lane Rogers, MD
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• Darlene C Sailer, MED CCC SLP
• Alena V Samal, OD
• Sarah Samples, M.S. CCC-SLP
• Amy Saul, MS CCC SLP

• Speech-Language Pathologist in Pelham, AL
• Providers in Pelham, AL by specialty
• Speech-Language Pathologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.