Individual provider Active NPI

Erin Russell, OTR/L

  • Occupational Therapist
  • Vancouver, WA
National Provider Identifier
1992990022
Registry record updated Nov 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1007 Issued in MT
Practice address
201 NE Park Plaza Dr Ste 246
Vancouver, WA 98684-5874
Phone
(360) 696-0588
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1007 MT Primary

Addresses

Primary practice location

201 NE Park Plaza Dr Ste 246
Vancouver, WA 98684-5874

Mailing address

201 NE Park Plaza Dr Ste 246
Vancouver, WA 98684-5874
Phone (360) 696-0588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090603000302 MT Practitioner - Occupational Therapist in Private Practice 8022168608 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1007MTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic, Inc CurrentSince May 1, 2010 Accepting new patients
Mosaic Rehabilitation, Inc Past Accepting new patients
Mosaic Inc PastSince May 1, 2010 Accepting new patients

Locations

11 W Main St
Ste 218
Belgrade, MT 59714
Phone (406) 388-4988

6325 Jackrabbit Ln
Ste A
Belgrade, MT 59714
Phone (406) 388-4988

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226188800000",
    "number": "1992990022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NE PARK PLAZA DR STE 246",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845874",
            "telephone_number": "360-696-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NE PARK PLAZA DR STE 246",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845874",
            "telephone_number": "360-696-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ERIN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2008-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MT",
            "license": "1007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.