Active NPI
Russell Garrison, PT
- Physical Therapist
- East Longmeadow, MA
National Provider Identifier
1962656561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17474
- Practice address
- 80 Denslow Rd
East Longmeadow, MA 01028-3103 - Phone
- (413) 526-9969
- Fax
- (413) 526-9960
- NPI assigned
- Nov 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 17474 | MA | Primary |
Addresses
Primary practice location
80 Denslow Rd
East Longmeadow, MA 01028-3103
Mailing address
80 Denslow Rd
East Longmeadow, MA 01028-3103
Phone (413) 526-9969
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28117 | Other | MA | HEALTH NEW ENGLAND |
| 043527497 | Other | MA | PIONEER |
| 103355100 | Other | DEPT OF LABOR | |
| 043527497 | Other | MA | GREATWEST |
| 043527497 | Other | MA | GIC/UNICARE |
| 043527497 | Other | MA | AETNA |
| 690675 | Other | MA | TUFTS |
| 000000035264 | Other | MA | BMC |
| 043527497 | Other | MA | CONSOLIDATED |
| 972730 | Other | MA | NETWOTK HEALTH |
| 043527 | Other | MA | CONNECTICARE |
| 9715568 | Medicaid | MA | |
| 043527497 | Other | MA | NORTH REGIONS |
| 043527497 | Other | MA | CIGNA |
| 043527497 | Other | MA | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Performance Rehabilitation of Western New England LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Occupational Therapist
- East Longmeadow, MA
- NPI 1740345818
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226275200000",
"number": "1962656561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 DENSLOW RD",
"city": "EAST LONGMEADOW",
"state": "MA",
"postal_code": "010283103",
"telephone_number": "413-526-9969",
"fax_number": "413-526-9960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 DENSLOW RD",
"city": "EAST LONGMEADOW",
"state": "MA",
"postal_code": "010283103",
"telephone_number": "413-526-9969",
"fax_number": "413-526-9960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRISON",
"first_name": "RUSSELL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-10",
"last_updated": "2008-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "17474",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NEW ENGLAND",
"identifier": "28117",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIONEER",
"identifier": "043527497",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR",
"identifier": "103355100",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREATWEST",
"identifier": "043527497",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GIC/UNICARE",
"identifier": "043527497",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "043527497",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "690675",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC",
"identifier": "000000035264",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONSOLIDATED",
"identifier": "043527497",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWOTK HEALTH",
"identifier": "972730",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "043527",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9715568",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH REGIONS",
"identifier": "043527497",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "043527497",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "043527497",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Longmeadow, MA
- Erin E Fuller, OTR/L
- Erin Evelyn Futrell, P.T.
- Meredith Gagne, OTR/L
- Sarah Gale, BCBA
- Jennifer Lundgren Garcia, AU.D.
- Allison Anne Giddings, DPT
- Mary Elizabeth Ginn, P.T.A.
- Golden Years Behavioral Health Group Inc.
- Golden Years Behavioral Health Group Inc.
- Golden Years Home Care Services of Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.