Individual provider Active NPI

Denise Blackard Russell, RN, FNP-C

  • Nurse Practitioner
  • Richardson, TX
National Provider Identifier
1972830909
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP114207 Issued in TX
Practice address
399 W Campbell Rd
Suite 101
Richardson, TX 75080-3595
Phone
(972) 238-1848
Fax
(972) 238-8735
NPI assigned
Nov 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP114207 TX Primary

Addresses

Primary practice location

399 W Campbell Rd
Suite 101
Richardson, TX 75080-3595

Mailing address

399 W Campbell Rd
Suite 101
Richardson, TX 75080-3595
Phone (972) 238-1848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110912000758 TX Practitioner - Nurse Practitioner 5092986646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

3000 Blackburn St
Suite 130
Dallas, TX 75204-2217
Phone (214) 599-8624

399 W Campbell Rd
Suite 101
Richardson, TX 75080-3615
Phone (972) 238-1848

Hospital & facility affiliations

  • Methodist Richardson Medical Center Hospital, Richardson, TX, CCN 450537
  • Medical City Plano Hospital, Plano, TX, CCN 450651
  • Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP114207TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Jan 1, 2012 Accepting new patients
Medhealth CurrentSince Jan 1, 2012 Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients
Richardson Physician Alliance Past Accepting new patients

Locations

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

399 W Campbell Rd
Ste 101
Richardson, TX 75080
Phone (972) 238-1848

613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700

Interoperability endpoints

  • Direct secure messaging: drussell30795@dm.mhd.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1972830909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 W CAMPBELL RD",
            "address_2": "SUITE 101",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803595",
            "telephone_number": "972-238-1848",
            "fax_number": "972-238-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 W CAMPBELL RD",
            "address_2": "SUITE 101",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803595",
            "telephone_number": "972-238-1848",
            "fax_number": "972-238-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DENISE",
        "middle_name": "BLACKARD",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP114207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.