THEODORE JOSEPH RUSSELL (NPI# 1295216992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295216992 |
| Entity Type | Individual |
| Full Name | THEODORE JOSEPH RUSSELL |
| Practice Address |
5209 Detroit Ave Cleveland OH 44102-2224 |
| Practice Telephone | 2164327200 |
| Mailing Telephone | 2164327200 |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
5209 DETROIT AVE |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44102-2224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962452169 | Maria A. Hussey | Registered Nurse | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2006-05-11 |
| 1700406956 | Alexis Boyden | Pharmacist | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2020-04-17 |
| 1710518352 | Ahmed Morsi | Behavior Technician | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2020-02-02 |
| 1972154433 | Lizandra Alicea | Social Worker | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2019-09-26 |
| 1407403082 | Victoria Kuryluk | Pharmacist | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2019-08-20 |
| 1558913970 | Macenna Greene | Behavior Technician | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2019-07-16 |
| 1265093447 | Danielle Bartsche | Behavior Technician | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2019-06-27 |
| 1669938122 | Deanna Leigh Schaeffer | Student in an Organized Health Care Education/Training Program | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2019-02-20 |
| 1467930644 | Joseph Edward Crouse | Case Manager/Care Coordinator | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2018-07-31 |
| 1407333412 | Olivia Campbell | Counselor | 5209 Detroit Ave, Cleveland, OH 44102-2224 | 2018-07-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174138259 | Christian Bracero | Home Health Aide | 1285 W 91 St Upstairs, Cleveland, OH 44102 | 2020-09-15 |
| 1639702855 | Ohio Wellness Transit | Non-emergency Medical Transport (VAN) | 3295 W. 97th St, Cleveland, OH 44102 | 2020-02-17 |
| 1538655642 | Alayah Wypasek | Case Manager/Care Coordinator | 3201 West 73rd, Cleveland, OH 44102 | 2018-07-02 |
| 1811489826 | Kimberly Ann Leftridge | Home Health Aide | 2088 W. 95th, Down, Cleveland, OH 44102 | 2018-06-05 |
| 1407352800 | Peace By Piece Cleveland | Community/Behavioral Health | 10237 Berea Rd, Cleveland, OH 44102 | 2018-04-04 |
| 1285130922 | Ruthanne Gurcze | Counselor | 3201 W 73rd Street, Cleveland, OH 44102 | 2018-04-02 |
| 1619486297 | Kimberly Billue | Home Health Aide | 2205 W 106th Street, Lower, Cleveland, OH 44102 | 2017-09-26 |
| 1114446473 | Kalia Marie Woods | Student in an Organized Health Care Education/Training Program | 2045 W 95th St, Cleveland, OH 44102 | 2017-09-18 |
| 1255858437 | Michelle Leann Genet | Counselor | 10427 Detroit Avenue, Cleveland, OH 44102 | 2017-08-28 |
| 1770033136 | Village Preparatory School IIi | Psychologist | 2220 W. 93rd St., Cleveland, OH 44102 | 2016-10-10 |
| Find all providers in zip 44102 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606755 | Kathy Ann Miller | Case Manager/Care Coordinator | 296 Colony Ln Nw, Cleveland, TN 37312-6411 | 2020-10-14 |
| 1437766243 | Marie L Clay | Case Manager/Care Coordinator | 8200 Rosewood Ave # Up, Cleveland, OH 44105-6683 | 2020-09-25 |
| 1073123311 | King Malone IIi | Case Manager/Care Coordinator | 1193 E 172nd St, Cleveland, OH 44119-3153 | 2020-08-02 |
| 1750990727 | Reginald Bagley I | Case Manager/Care Coordinator | 2728 Euclid Ave Ste 4004th, Cleveland, OH 44115-2429 | 2020-07-27 |
| 1497364681 | James Gordon | Case Manager/Care Coordinator | 896 E 73rd St, Cleveland, OH 44103-1792 | 2020-07-24 |
| 1558988204 | Jamil Brooks | Case Manager/Care Coordinator | 23612 Mccann St, Cleveland, OH 44128-5250 | 2020-06-29 |
| 1629692801 | Theodore Williams Iv | Case Manager/Care Coordinator | 7271 Engle Rd Ste 207, Cleveland, OH 44130-8404 | 2020-06-03 |
| 1629690920 | Vincent Van Johnson | Case Manager/Care Coordinator | 17325 Euclid Ave Ste 4028, Cleveland, OH 44112-1270 | 2020-05-11 |
| 1932728508 | Janayia Thompson | Case Manager/Care Coordinator | 12395 Mccracken Rd # A-up, Cleveland, OH 44125-2967 | 2020-04-13 |
| 1942836309 | Shirley Tucker | Case Manager/Care Coordinator | 2728 Euclid Ave, Cleveland, OH 44115-2429 | 2020-03-18 |
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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.