Individual provider Active NPI

Russell Salmon, AT

  • Physical Therapist
  • Dothan, AL
National Provider Identifier
1982037339
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
345 Healthwest Dr
Dothan, AL 36303-2053
Phone
(334) 793-2663
Fax
(334) 836-2247
NPI assigned
Aug 20, 2013
Last updated
Feb 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Athletic Trainer 2255A2300X 1515 AL

Addresses

Primary practice location

345 Healthwest Dr
Dothan, AL 36303-2053

Mailing address

PO Box 729
Dothan, AL 36302-0729
Phone (334) 793-2663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180427000263 AL Practitioner - Physical Therapist in Private Practice 8628332624 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Spine and SportGroup PAC ID 8729422753, 3 clinicians

Practice addresses (Care Compare)

1008 Boll Weevil Cir
Suite C
Enterprise, AL 36330-3400
Phone (334) 352-3331

Merit-based Incentive Payment System (MIPS)

Final score
86.04 of 100Reported as group
Quality
90
Improvement activities
40
Cost
71.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1515ALMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Alabama, LLC Physical Therapist CurrentSince Mar 29, 2022 Accepting new patients
Southern Spine and Sport Physical Therapist CurrentSince Jan 10, 2024 Accepting new patients

Locations

1877 Cherokee Ave SW
Cullman, AL 35055
Phone (256) 727-1701

1008 Boll Weevil Cir
Ste C
Enterprise, AL 36330
Phone (334) 352-3331

2200 Ozark Hwy
Ste E
Enterprise, AL 36330
Phone (334) 352-3331

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1982037339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363020729",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 HEALTHWEST DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032053",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMON",
        "first_name": "RUSSELL",
        "credential": "AT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-20",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AL",
            "license": "1515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.