RUSSELL MASTERSON (NPI# 1851339220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851339220 |
| Entity Type | Individual |
| Full Name | RUSSELL MASTERSON |
| Credential | PHD |
| Practice Address |
878 109th Ave N Naples FL 34108-1821 |
| Practice Telephone | 2395968416 |
| Practice Fax Number | 2395131915 |
| Mailing Telephone | 2395968416 |
| Mailing Fax Number | 2395131915 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2008-09-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
FL2435 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 75199 | 01 |
| FL | RAILROAD MEDICARE | P00146358 | 01 |
| Street Address |
878 109TH AVE N |
| City | NAPLES |
| State | FL |
| Zip Code | 34108-1821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528050788 | Sherry D Azar-chesterton | Nurse Practitioner | 878 109th Ave N, Naples, FL 34108-1814 | 2005-08-15 |
| 1124541321 | Lauren Bledsoe | Physician Assistant | 878 109th Ave N, Naples, FL 34108-1814 | 2017-07-19 |
| 1932539939 | Dr. Russell Masterson Pa | Psychologist | 878 109th Ave N, Naples, FL 34108-1814 | 2013-11-13 |
| 1134409535 | Naples Peritoneal Dialysis Center,llc | Legal Medicine | 878 109th Ave N, Naples, FL 34108-1821 | 2011-08-17 |
| 1386972172 | Carline Cenatus | Physician Assistant | 878 109th Ave N, Naples, FL 34108-1814 | 2009-12-07 |
| 1740422187 | Nijal Sheth | Internal Medicine | 878 109th Ave N, Naples, FL 34108-1814 | 2009-03-31 |
| 1295908598 | Teresa Marie Liccardi | Internal Medicine | 878 109th Ave N, Naples, FL 34108-1814 | 2008-04-08 |
| 1235254699 | Naples Nephrology P A | Specialist | 878 109th Ave N, Naples, FL 34108-1821 | 2007-03-21 |
| 1104858968 | Vera Stricevic | Internal Medicine | 878 109th Ave N, Naples, FL 34108-1821 | 2006-07-06 |
| 1376579607 | Kidney Institute of Naples, LLC | Clinic/Center | 878 109th Ave N, Naples, FL 34108-1821 | 2006-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417422262 | Alejandra Herrera Munoz | Occupational Therapist | 646 103rd Ave N, Naples, FL 34108 | 2018-10-08 |
| 1912402983 | Cvs Aoc Services, L.L.C. | Audiologist-Hearing Aid Fitter | 8863h Tamiami Trl N, Naples, FL 34108 | 2018-03-29 |
| 1861886863 | Zounds Hearing | Durable Medical Equipment & Medical Supplies | 9331 Tamiami Trail, Naples, FL 34108 | 2015-03-27 |
| 1750651220 | Dr. Alfonso Olivos, P.a. | Family Medicine | 873 101 Avenue N., Naples, FL 34108 | 2011-12-30 |
| 1083901367 | Gregory Alan Mazur | Podiatrist | 9915 Tamiami Trl N Ste 1, Naples, FL 34108 | 2011-07-07 |
| 1124253398 | G B Fisher IIi Do Pa | Ophthalmology | 875 105 Ave North, Naples, FL 34108 | 2009-05-18 |
| 1134378466 | Susanna Alis | Counselor | 9853 Tamiami Trl N Ste 227c, Naples, FL 34108 | 2008-09-10 |
| 1194995720 | William Nicholas Sullivan | Dentist | 6100 Trail Blvd North, Suite 1, Naples, FL 34108 | 2008-03-11 |
| 1285838219 | John Woolman Cox | Dermatology | 650 Bridgeway Lane, Naples, FL 34108 | 2007-06-13 |
| 1780888263 | Gerald Frank Levens | Family Medicine | 1175 Creekside Pkwy Ste 200, Naples, FL 34108 | 2007-06-11 |
| Find all providers in zip 34108 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407419831 | Avp Assessment Services, LLC | Psychologist | 4851 Tamiami Trl N, Naples, FL 34103-3096 | 2019-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962019935 | Michelle Johnson | Psychologist | 22513 Se 61st Ave, Hawthorne, FL 32640-3640 | 2020-09-24 |
| 1538785837 | Change The Narrative Counseling LLC | Psychologist | 20417 Berrywood Ln, Tampa, FL 33647-3476 | 2020-06-23 |
| 1689210791 | Alexis Vaughn | Psychologist | 203 Ne Montana St, Lake City, FL 32055-2183 | 2019-11-24 |
| 1316581101 | Melissa Singleton | Psychologist | 4728 Lexington Ave, Jacksonville, FL 32210-3218 | 2019-11-05 |
| 1407408123 | R Ramos Inc. | Psychologist | 2285 St R 580, S-210, Clearwater, FL 33763-1111 | 2019-07-12 |
| 1215599766 | Stephanie Rita Mcdonough | Psychologist | 1600 Sw Archer Rd Fl Roomg901, Gainesville, FL 32610-3003 | 2019-07-05 |
| 1013573039 | Antionette Jarshawn Miller-maultsby | Psychologist | 4401 Will Scarlet Rd, Jacksonville, FL 32208-1154 | 2019-05-15 |
| 1376002063 | Lakeyta Nacole Givens | Psychologist | 514 Joan St, Macclenny, FL 32063-2618 | 2019-03-13 |
| 1558841684 | Kevin D Roberts | Psychologist | 20 First Street Apt 5, St. Augustine, FL 32084 | 2018-08-17 |
| 1295280428 | Psych Aid Corp | Psychologist | 1300 Nw 84th Ave, Doral, FL 33126-1500 | 2016-08-17 |
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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.