Jai Kieron Rene Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

BBH-LCSW-LIC-38038 Issued in MT

Practice address

2135 Charlotte St Ste 2
Bozeman, MT 59718-2741

Phone

(206) 930-8970

NPI assigned

Jun 7, 2019

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

Eligible to order & refer

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

Green means eligible to order or refer.

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1972162683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 385",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597710385",
            "telephone_number": "206-930-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 CHARLOTTE ST STE 2",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597182741",
            "telephone_number": "206-930-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JAI",
        "middle_name": "KIERON RENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-38038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Ruggles, PT, DPT
• Vera C Ruhlmann
• Jennifer Jane Runkel, APRN
• Alice Running, PHD APRN
• Merrick Denae Running, DPT
• Catherine Ryan
• Megan Kristine Ryan, ATC
• Louise Ryder
• Marilyn Marjorie Ryley, L.C.P.C.
• Jeffrey Sabatka

• Clinical Social Worker in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.