Robert Luis Russell

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-21-191537 Issued in FL

Practice address

3790 Dairy Rd
Melbourne, FL 32904-7630

Phone

(850) 294-1982

NPI assigned

Mar 15, 2022

Last updated

Mar 15, 2022By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1982352217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 MARY ST",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329046742",
            "telephone_number": "850-294-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3790 DAIRY RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329047630",
            "telephone_number": "850-294-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ROBERT",
        "middle_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-21-191537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rush Chiropractic Inc. (Priest Chiropractic)
• Evan Michael Rush, D.C.
• Patricia Diane Rush
• Sommer Nicole Rush, PA-C
• Rebekah Russell, APRN, PMHNP-BC, MSN
• Jeanette Christine Ruth
• RX Care 16 LLC (Melbourne Drugs)
• Dennis Ryan, PA
• John Joseph Ryan, PT
• Leslie M Ryan, DC

• Behavior Technician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.