Alyssa Lynne Russell, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI1393 Issued in ME

Practice address

75 Market St Ste 304
Portland, ME 04101-5040

Phone

(207) 400-6188

NPI assigned

May 17, 2021

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

State licenses

Practice roles

Locations

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

• Kaleidoscope Eating Disorders and Diet Recovery Center

  • Health Service Clinic/Center
  • Portland, ME
  • NPI 1356960728
  NPD

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1972177863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LINDY LN",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040326338",
            "telephone_number": "516-816-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MARKET ST STE 304",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041015040",
            "telephone_number": "207-400-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ALYSSA",
        "middle_name": "LYNNE",
        "credential": "RDN, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI1393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott F Rusk, MD
• Russell Family Dentistry LLC
• Aura Russell-Bedder, LCSW
• Jill Christina Russell-Morey
• Lydia Russell-Roy, MD
• Benjamin Lincoln Russell, DO
• Devin Russell
• Emily B. Russell, LCSW
• Erich Russell, D.O
• George H Russell, MD

• Registered Dietitian in Portland, ME
• Providers in Portland, ME by specialty
• Registered Dietitian in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.