Adam Russell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5426 Issued in NC

Practice address

487 Lake Concord Rd NE
Concord, NC 28025-2934

Phone

(704) 403-0291

NPI assigned

Nov 20, 2015

Last updated

Nov 20, 2015By 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": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1992179402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 COURTLAND CT",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280817172",
            "telephone_number": "704-403-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 LAKE CONCORD RD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252934",
            "telephone_number": "704-403-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ADAM",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "5426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Petrovich Rusev
• Ambredawn Tacara Rush, AGPCNP
• Tamara Moser Rush, LCMHCA
• Lorraine Rushing, LPCA
• Emily Rusmisell, FNP-BC
• Alisa Russell, M.S.
• Ann Russell, LCMHC
• Jessica D. Russell, M. ED, LPCA
• Jillian Marie Russell, MS CCC-SLP
• Mary C. Russell, MD

• Physical Therapy Assistant in Concord, NC
• Providers in Concord, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.