MARK L RUSSELL (NPI# 1609164532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609164532 |
| Entity Type | Individual |
| Full Name | MARK L RUSSELL |
| Credential | APRN |
| Practice Address |
125 Lasalle Rd West Hartford CT 06107-2322 |
| Practice Telephone | 8609061289 |
| Practice Fax Number | 8609061269 |
| Mailing Telephone | 8609061289 |
| Mailing Fax Number | 8609061269 |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2015-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 077986 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | LICENSE | 077986 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831710771 | Mark William Russell | Dentist | 461 Western Blvd Ste 104, Jacksonville, NC 28546-7637 | 2020-05-01 |
| 1144752221 | Mark Russell | Social Worker | 475 Sykesville Troutville Rd, Punxsutawney, PA 15767-4367 | 2017-03-29 |
| 1154767267 | Mark Stephen Russell Jr. | Counselor | 3901 Airport Fwy Ste 107, Bedford, TX 76021-6117 | 2013-05-15 |
| 1437314366 | Mark William Russell | Community Health Worker | 108 Schooner Landing Dr, Edenton, NC 27932-8833 | 2008-07-21 |
| 1306867049 | Mark Duane Russell | Specialist/Technologist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2006-07-21 |
| 1639137540 | Mark Russell | Internal Medicine | 13024 Hesperia Rd Ste 103, Victorville, CA 92395-8303 | 2006-05-02 |
| 1689671315 | Mark Dale Russell | Chiropractor | 5309 44th St, Lubbock, TX 79414-1321 | 2005-07-07 |
| 1154827756 | Mark Russell | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2018-04-03 |
| 1033654967 | Mark Russell | Pharmacist | 2920 Knoxville Center Dr, Knoxville, TN 37924-2013 | 2017-01-02 |
| 1477097392 | Mark Russell | Social Worker | 302 S Spring St, Tupelo, MS 38804-4853 | 2016-12-12 |
| Street Address |
125 LASALLE RD |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06107-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043325962 | Peter Steven Katz | Dentist | 125 Lasalle Rd, 306, West Hartford, CT 06107-2322 | 2006-08-20 |
| 1194337485 | Susan Marie Kamin | 125 Lasalle Rd, West Hartford, CT 06107-2322 | 2020-08-19 | |
| 1952847725 | Verna Lukehart | Dietitian, Registered | 125 Lasalle Rd, Suite 208, West Hartford, CT 06107-2322 | 2017-01-17 |
| 1225481484 | Cassidy Bancroft | Dietitian, Registered | 125 Lasalle Rd, West Hartford, CT 06107-2322 | 2016-07-22 |
| 1578923785 | Rebecca Mckeown | Dietitian, Registered | 125 Lasalle Rd, West Hartford, CT 06107-2322 | 2016-03-01 |
| 1780044990 | Alisha Sanzone | Dietitian, Registered | 125 Lasalle Rd, West Hartford, CT 06107-2322 | 2016-03-01 |
| 1639585995 | Bonnie Wilson | Dietitian, Registered | 125 Lasalle Rd, West Hartford, CT 06107-2322 | 2014-07-08 |
| 1548676877 | Pounds, Medical Weight Loss Transformation, PC | Obstetrics & Gynecology | 125 Lasalle Rd, Suite 208, West Hartford, CT 06107-2322 | 2014-07-08 |
| 1679903884 | Lisa Shapiro | Dietitian, Registered | 125 Lasalle Rd, Suite 208, West Hartford, CT 06107-2322 | 2013-11-25 |
| 1205260684 | Linda Armistead | Registered Nurse | 125 Lasalle Rd, Suite 208, West Hartford, CT 06107-2322 | 2013-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538783659 | Briana Deslauriers | Audiologist | Solinsky Hearing Center, 1013 Farmington Avenue, West Hartford, CT 06107 | 2020-06-04 |
| 1750851366 | Candyce Yvonne Scott | Counselor | 61 S Main St Ste 310, West Hartford, CT 06107 | 2018-11-27 |
| 1124524798 | Image of Light Mental Health Services, LLC | Nurse Practitioner | 45 S Main St Ste 70, West Hartford, CT 06107 | 2018-04-03 |
| 1235632498 | Leila Fussell | Student in an Organized Health Care Education/Training Program | 175 Garfield Rd, West Hartford, CT 06107 | 2018-03-14 |
| 1568818169 | Gail Southard Canzano | Psychologist | 81 S. Main St, West Hartford, CT 06107 | 2016-05-12 |
| 1922470939 | Optimal Wellness of West Hartford | Family Medicine | 1001 Farmington Ave., West Hartford, CT 06107 | 2015-10-29 |
| 1518369925 | Maria Eugenia Garcia-ayala | Psychiatry & Neurology | 65 Memorial Rd Ste 508, West Hartford, CT 06107 | 2014-09-17 |
| 1376884981 | Robert Moss | Pediatrics | 174 Wood Pond Road, West Hartford, CT 06107 | 2013-03-06 |
| 1659630960 | Michael John Grille | Anesthesiology | 65 Memorial Rd #435, Hartford Hospital Pain Treatment Center, West Hartford, CT 06107 | 2012-05-07 |
| 1518268010 | Parsons Health Co. Inc | Legal Medicine | 61 So Main Street, Suite 202, West Hartford, CT 06107 | 2010-11-15 |
| Find all providers in zip 06107 | ||||
| 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 |
|---|---|---|---|---|
| 1801377502 | Dana Andreo | Nurse Practitioner | 65 Memorial Rd Ste 435, West Hartford, CT 06107-4205 | 2018-08-22 |
| 1699097048 | James Mark Lazenby | Nurse Practitioner | 134 Woodrow St, West Hartford, CT 06107-3061 | 2010-02-25 |
| 1518979855 | Amy Louise Smith- Bassett | Nurse Practitioner | 74 Park Rd Ste 2, West Hartford, CT 06119-1898 | 2006-08-13 |
| 1982615258 | Margaret Brigham | Nurse Practitioner | 97 South St, Suite 101, West Hartford, CT 06110-1960 | 2006-08-11 |
| 1184656647 | Gladys Quinones | Nurse Practitioner | 1007 Farmington Ave Ste 3a, West Hartford, CT 06107-2107 | 2006-07-07 |
| 1407816697 | Danielle R Marenco | Nurse Practitioner | 345 N Main St Ste 318, West Hartford, CT 06117-2508 | 2006-03-23 |
| 1144299694 | Rebekah Venezia Pointek | Nurse Practitioner | 20 Isham Rd Ste 100, West Hartford, CT 06107-2204 | 2006-03-16 |
| 1699320937 | Amy Kolaczenko | Nurse Practitioner | 631 S Quaker Ln, West Hartford, CT 06110-1026 | 2019-08-05 |
| 1225492507 | Jessica Urban-jack | Nurse Practitioner | 1162 New Britain Ave, West Hartford, CT 06110-2410 | 2016-04-12 |
| 1063875094 | Camille Margaux Karalekas | Nurse Practitioner | 7 N Main St, West Hartford, CT 06107 | 2016-03-29 |
| Find all providers in WEST HARTFORD | ||||
| City | WEST HARTFORD |
| Zip Code | 06107 |
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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.