Russell Denea, MD, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

RUSSELL DENEA, MD, LLC

Practice address

4102 A1A S
Saint Augustine, FL 32080-6942

Phone

(904) 471-1300

Fax

(904) 471-1333

NPI assigned

Nov 8, 2017

Last updated

Dec 27, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Russell Denea, MDNPI 1235175977

Title

Owner

Phone

(904) 471-1300

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell Denea, MD

  • Psychiatry Physician
  • St Augustine, FL
  • NPI 1235175977
  Authorized official Same address or phone

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514332800000",
    "number": "1972016210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 A1A S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320806942",
            "telephone_number": "904-471-1300",
            "fax_number": "904-471-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 A1A S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320806942",
            "telephone_number": "904-471-1300",
            "fax_number": "904-471-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL DENEA, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-12-27",
        "status": "A",
        "authorized_official_last_name": "DENEA",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-471-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rural Health Care Inc. (Aza Health)
• Rural Health Care, Incorporated (Aza Health)
• Rural Health Care, Incorporated (Aza Health)
• Jennifer Lynn Rusich
• Ivory Russ
• Caitlin Owen Russell
• Helena Russell, APRN
• Valerie A Russell, LCSW
• Alexandra Russick, RBT
• Kristin Russo

• Psychiatry Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; 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.