IDA ALICIA RUSSELL (NPI# 1700841038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700841038 |
| Entity Type | Individual |
| Full Name | IDA ALICIA RUSSELL |
| Credential | ATC |
| Practice Address |
424 N University Ave Little Rock AR 72205-3109 |
| Mailing Address |
3408 Silica Heights Rd Benton AR 72015-5622 |
| Practice Telephone | 5016610336 |
| Practice Fax Number | 5016610412 |
| Mailing Telephone | 5018606601 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
293 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
424 N UNIVERSITY AVE |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-3109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437113727 | Terri R Cohen | Podiatrist | 424 N University Ave, Little Rock, AR 72205 | 2006-04-13 |
| 1285746529 | Little Rock Foot Clinic, Pa | Podiatrist | 424 N University Ave, Little Rock, AR 72205-3109 | 2006-08-31 |
| 1023021136 | Sarah Olney | Physical Therapist | 424 N University Ave, Little Rock, AR 72205-3109 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
| 1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
| 1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
| 1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
| 1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
| 1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
| 1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
| 1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
| 1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| Find all providers in zip 72205 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952893554 | Corinna Alysia Papps | Specialist/Technologist | 104 Buckland Pl, Little Rock, AR 72223-4567 | 2018-05-31 |
| 1124535075 | Alexandra Glenn | Specialist/Technologist | 15 Ridgehaven Ct, Little Rock, AR 72211-2253 | 2018-01-01 |
| 1396255030 | Jessica Sandbulte | Specialist/Technologist | 1942 Log Ave, Little Rock, IA 51243-7514 | 2017-10-09 |
| 1982129235 | Zania Lafaye Stewart | Specialist/Technologist | 1621 Dr Martin Luther King Dr, Little Rock, AR 72202-6068 | 2017-08-08 |
| 1326498080 | Kellye O'neal | Specialist/Technologist | 13420 David O Dodd Rd, Little Rock, AR 72210-2724 | 2016-06-14 |
| 1679922553 | Madeline Awtrey | Specialist/Technologist | 11900 Pleasant Ridge Rd, Apt. #1324, Little Rock, AR 72223-2348 | 2016-06-10 |
| 1386091031 | Tim Driedric | Specialist/Technologist | 3400 S. Bowman Rd. Apt 812, Little Rock, AR 72211 | 2016-05-23 |
| 1477955524 | Matthew Holt | Specialist/Technologist | 10815 Colonel Glenn Rd, Little Rock, AR 72204-8011 | 2014-09-19 |
| 1033533922 | Jacqueline Diane Ross | Specialist/Technologist | 12509 Pleasant Forest Dr, Little Rock, AR 72212-2214 | 2014-02-12 |
| 1427261114 | Brian E Mahoney | Specialist/Technologist | 8907 Kanis Road, Ste. 400, Little Rock, AR 72205 | 2007-05-08 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72205 |
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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.