MR. RUSSELL JOHNSON (NPI# 1447205554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447205554 |
| Entity Type | Individual |
| Full Name | MR. RUSSELL JOHNSON |
| Practice Address |
601 Old Wagner Rd Suite 101 Petersburg VA 23805-9313 |
| Practice Telephone | 8045242260 |
| Practice Fax Number | 8045240096 |
| Mailing Telephone | 8045242260 |
| Mailing Fax Number | 8045240096 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2016-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 0101045410 | VA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 194501 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659782787 | Russell Laroy Johnson | Contractor | 11629 Sueno Ct., Fontana, CA 92337 | 2014-05-12 |
| 1497198402 | Russell Andrew Johnson | Emergency Medicine | 100 Ucla Medical Plaza Suite 490, Los Angeles, CA 90095-1103 | 2013-04-09 |
| 1790990679 | Russell E Johnson | Chiropractor | 1519 Grundy Ave, Holbrook, NY 11741-2106 | 2007-05-13 |
| 1417172966 | Russell Johnson Jr. | Hearing Instrument Specialist | 1522 Gregg St, Columbia, SC 29201-3530 | 2007-04-17 |
| 1861423790 | Russell Talmage Johnson | Specialist/Technologist | 1190 S 18th Street Ext, Oxford, MS 38655-5378 | 2006-07-06 |
| 1437185378 | Russell K Johnson | Podiatrist | 114 W Castellano Dr, El Paso, TX 79912-6119 | 2006-06-23 |
| 1003801283 | Russell F Johnson | Radiology | 615 N Michigan St, 1st Floor, South Bend, IN 46601-1033 | 2005-09-14 |
| 1528413549 | Russell D Johnson | Counselor | 2238 E. Ginter Road, Sunnyside Unified School District No. 12, Tucson, AZ 85706 | 2016-04-27 |
| 1710345483 | Russell Johnson | Physician Assistant | 2801 W Kinnickinnic River Pkwy Ste 370, Milwaukee, WI 53215-3678 | 2016-02-09 |
| 1881085298 | Russell Ivan Johnson | Dentist | 7703 Floyd Curl Dr, San Antonio, TX 78229-3901 | 2015-02-08 |
| Street Address |
601 OLD WAGNER RD SUITE 101 |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-9313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518939594 | Saeed Anwar | Anesthesiology | 601 Old Wagner Rd, Petersburg, VA 23805-9313 | 2006-02-03 |
| 1629686449 | Virginia Interventional Pain and Spine LLC | Anesthesiology | 601 Old Wagner Rd, Petersburg, VA 23805-9313 | 2020-07-17 |
| 1427544048 | Jsnv Medical LLC | Podiatrist | 601 Old Wagner Rd, Petersburg, VA 23805-9313 | 2018-07-06 |
| 1033652169 | Elizabeth Marie King | Nurse Practitioner | 601 Old Wagner Rd, Petersburg, VA 23805-9313 | 2016-11-21 |
| 1902357387 | Anesthesia Services Associates, Pllc | Durable Medical Equipment & Medical Supplies | 601 Old Wagner Rd, Suite 100, Petersburg, VA 23805-9313 | 2016-10-20 |
| 1417407594 | Anesthesia Services Associates | Anesthesiology | 601 Old Wagner Rd, Petersburg, VA 23805-9313 | 2016-10-12 |
| 1245685551 | Anesthesia Services Associates Pllc | Anesthesiology | 601 Old Wagner Rd, Unit 100, Petersburg, VA 23805-9313 | 2016-04-25 |
| 1528420544 | Jaimie Sarcon Tahir | Nurse Practitioner | 601 Old Wagner Rd, Petersburg, VA 23805-9313 | 2016-03-28 |
| 1295194983 | Vmg Specialists PC | Internal Medicine | 601 Old Wagner Rd, Suite 102, Petersburg, VA 23805-9313 | 2016-02-23 |
| 1760812945 | Best Health Care Center LLC | Internal Medicine | 601 Old Wagner Rd, Bldg D, Petersburg, VA 23805-9313 | 2013-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083754790 | Professional Health Care, Inc. | Specialist | 849 S Sycamore St, Suite E, Petersburg, VA 23803-5801 | 2007-02-08 |
| 1457311656 | Myung-sup Kim Md Pa | Specialist | Rt 55 West, Petersburg, WV 26847 | 2006-03-23 |
| 1023086915 | Frank F Shieh | Specialist | 603 S Sycamore St, Petersburg, VA 23803 | 2006-03-08 |
| 1972983393 | Grant Memorial Hospital | Specialist | 65 Hospital Dr Ste 103, Petersburg, WV 26847-9549 | 2015-06-01 |
| 1316150006 | Southside Ob-gyn, Inc. | Specialist | 600 S Sycamore St, Petersburg, VA 23803-5815 | 2007-05-08 |
| 1497872980 | Team Rehab, Inc | Specialist | 95 Medical Park Blvd, Petersburg, VA 23805-9280 | 2007-03-22 |
| 1447365945 | Central Virginia Oncology, Inc. | Specialist | 700 S Sycamore St, Ste 10, Petersburg, VA 23803 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952004 | Patricia Maureen Williams | Specialist | 175 W Campus Dr, 110 Lr Hall, Blacksburg, VA 24061-1034 | 2020-11-02 |
| 1497360028 | Ann L Swanson | Specialist | 872 Garrow Rd, Newport News, VA 23608-3365 | 2020-09-10 |
| 1093338915 | Bridget Elizabeth Poindexter | Specialist | 103 Madison St Apt C, Radford, VA 24141-1878 | 2020-05-27 |
| 1285257246 | Zamjams Enterprises LLC | Specialist | 1600 N Coalter St Ste 7, Staunton, VA 24401-2500 | 2020-05-26 |
| 1427670538 | Megan Cone | Specialist | 6236 Willow Glen Rd, Midlothian, VA 23112-2230 | 2020-05-12 |
| 1033739529 | Maureen Marguerite Loftus | Specialist | 8321 Old Courthouse Rd Ste 130, Vienna, VA 22182-3817 | 2020-04-24 |
| 1972132090 | Alissa S Rexo | Specialist | 25251 Beach Place, Chantilly, VA 20152 | 2020-04-02 |
| 1821626235 | Tidewater Surgical | Specialist | 1732 S Park Ct, Chesapeake, VA 23320-8934 | 2020-03-31 |
| 1699307520 | Latia Tisdale | Specialist | 2520 Professional Rd Ste D, North Chesterfield, VA 23235-3267 | 2020-02-08 |
| 1013473081 | Whitney Matheson | Specialist | 6803 Dallas Rd, Roanoke, VA 24019-2310 | 2019-02-14 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
Please comment or provide details below to improve the information on MR. RUSSELL JOHNSON.
| 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.