JOHN RUSSELL (NPI# 1104237130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104237130 |
| Entity Type | Individual |
| Full Name | JOHN RUSSELL |
| Practice Address |
1340 Charles St Suite 300 Rockford IL 61104 |
| Mailing Address |
Po Box 78866 Milwaukee WI 53278-8866 |
| Practice Telephone | 7796968800 |
| Mailing Telephone | 7796967150 |
| Mailing Fax Number | 7796967342 |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2018-07-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 041.368559 | IL | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | 209-011657 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821231663 | John Russell IIi | Dentist | 206 N Brookmoore Dr, Columbus, MS 39705-2020 | 2009-04-09 |
| 1417106196 | John Edwin Russell | Physical Medicine & Rehabilitation | 6455 Toucan Trl, Spring Hill, FL 34607-2642 | 2008-09-17 |
| 1831221159 | John Clark Russell | Dentist | 2010 Court St, Beatrice, NE 68310-3209 | 2007-03-12 |
| 1811023963 | John Thomas Russell | Dentist | 1116 West St, Suite B, Annapolis, MD 21401-3608 | 2007-02-25 |
| 1003957515 | John Wesley Russell | Dentist | 3253 Mccracken St, Muskegon, MI 49441 | 2007-02-08 |
| 1902958077 | John Douglas Russell | Dentist | 4178 Ashby Court, Shasta Lake City, CA 96019 | 2007-01-17 |
| 1619066156 | John Grover Russell | Specialist | 8188 W Bartlett Rd, Casa Grande, AZ 85222-7336 | 2006-10-12 |
| 1003918137 | John C Russell | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2731 Oak Bluff, San Antonio, TX 78230 | 2006-09-01 |
| 1720013204 | John Russell | Urology | 22 Hartford St # Sr, Houlton, ME 04730-1844 | 2006-07-12 |
| 1619925294 | John Andrew Haws Russell | Obstetrics & Gynecology | 106 Liner Dr, Greenwood, SC 29646 | 2006-05-05 |
| Street Address |
1340 CHARLES ST SUITE 300 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418143 | Kathleen Edna Williams | Nurse Practitioner | 1340 Charles St, Ste 201, Rockford, IL 61104 | 2005-06-23 |
| 1124526652 | Drew W Pearson | Registered Nurse | 1340 Charles St, Rockford, IL 61104-2200 | 2018-01-30 |
| 1417483322 | Andrea K Mehlbaum | Registered Nurse | 1340 Charles St, Suite 200, Rockford, IL 61104-2200 | 2017-05-11 |
| 1770030801 | Mary L Marshall | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104-2200 | 2016-09-07 |
| 1518318047 | Laura G Padron | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2016-06-27 |
| 1689056285 | Mary E Novotny | Registered Nurse | 1340 Charles St, Suite 100, Rockford, IL 61104 | 2015-06-19 |
| 1356759294 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2014-07-23 |
| 1760824114 | Kaitlin L Georgiafandis | Physician Assistant | 1340 Charles St, Rockford, IL 61104-2200 | 2013-07-26 |
| 1326486895 | Daniel Clark Painter | Physical Medicine & Rehabilitation | 1340 Charles St, Suite 100, Rockford, IL 61104-2200 | 2013-06-06 |
| 1205106341 | Erica S Cook | Nurse Practitioner | 1340 Charles St, Suite 400, Rockford, IL 61104 | 2012-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265052401 | Jet Healthcare LLC | Nurse Practitioner | 5979 Nebeshone Ln, Rockford, IL 61103-8926 | 2020-04-17 |
| 1760023162 | Mh Health Care Services, PC | Nurse Practitioner | 5943 E Riverside Blvd, Rockford, IL 61114-4935 | 2019-10-07 |
| 1235792045 | Michelle Anna Barrett | Nurse Practitioner | 6000 E State St Ste 1, Rockford, IL 61108-2521 | 2019-04-17 |
| 1780177030 | Emily Glass Mims | Nurse Practitioner | 9518 Us Highway 231, Rockford, AL 35132-5551 | 2018-06-12 |
| 1003269895 | Jason Roberts | Nurse Practitioner | 199 Longview Dr, Rockford, MI 49341-1130 | 2016-07-18 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1588800700 | Sylvia Ann Garza | Nurse Practitioner | 3401 N. Perryville Rd, Rockford Health Physicians, Rockford, IL 61114 | 2008-12-17 |
| 1295955284 | Jennifer Lee Binder | Nurse Practitioner | 2327 Nebraska Rd, Rockford, IL 61108-7510 | 2007-05-01 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1902995087 | Lori Ann Schultz | Nurse Practitioner | 1235 N Mulford Rd Ste 205, Rockford, IL 61107-3879 | 2006-10-12 |
| Find all providers in ROCKFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.