MRS. MARY MONICA RUSSELL (NPI# 1912234071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912234071 |
| Entity Type | Individual |
| Full Name | MRS. MARY MONICA RUSSELL |
| Other Name | MARY MONICA BLAINE |
| Credential | LRD, CDE |
| Practice Address |
1702 East Rose Creek Parkway South Fargo ND 58104-6834 |
| Mailing Address |
Landstuhl Regional Medical Center Cmr 402 Apo AE 09180 |
| Practice Telephone | 7012394946 |
| Mailing Telephone | 0114915221310207 |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2009-11-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 151 | ND | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720551203 | Mary Kathleen Russell | Speech-Language Pathologist | 110 E Huron Ave Ste A, Bad Axe, MI 48413-1312 | 2019-01-07 |
| 1609253145 | Mary Kathleen Russell | Ophthalmology | 259 E Erie St Ste 1500, Chicago, IL 60611-3111 | 2015-05-05 |
| 1265837025 | Mary Russell | Nurse Practitioner | 1519 Clifftop Ave, San Marcos, CA 92078-1075 | 2014-10-22 |
| 1538413323 | Mary Ann Russell | Counselor | 1309 Pioneer Ave Ne, Olympia, WA 98506-3356 | 2012-11-01 |
| 1194019158 | Mary Elizabeth Russell | Physical Medicine & Rehabilitation | 920 Medical Plaza Dr Ste 340, Shenandoah, TX 77380-3256 | 2011-06-07 |
| 1659435915 | Mary Catherine Russell | Nurse Practitioner | 3710 Sw Us Veterans Hosp Rd, Portland, OR 97207 | 2006-12-21 |
| 1548320047 | Mary E Russell | Internal Medicine | 343 Russell St, Carlisle, MA 01741-1713 | 2006-12-12 |
| 1083711808 | Mary Michelle Russell | Physical Therapist | 1 Bates Blvd Ste 100, Orinda, CA 94563-2800 | 2006-09-20 |
| 1447258652 | Mary C Russell | Nurse Practitioner | 180 Emory Rd, Blaine, TN 37709-2420 | 2005-07-12 |
| 1417518747 | Mary Eileen Kumah Russell | Nurse Practitioner | 6644 E Baywood Ave, Mesa, AZ 85206-1747 | 2019-06-26 |
| Street Address |
1702 EAST ROSE CREEK PARKWAY SOUTH |
| City | FARGO |
| State | ND |
| Zip Code | 58104-6834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003446329 | Alexis Ann Allen | Dietitian, Registered | 1749 38th St S, Fargo, ND 58103-4442 | 2020-01-26 |
| 1487171245 | Presticor, Inc. | Dietitian, Registered | 2603 Kirsten Ln S Ste 104, Fargo, ND 58104-5204 | 2017-08-23 |
| 1558882092 | Stephanie E Scott | Dietitian, Registered | 2701 University Dr S, Fargo, ND 58103-6027 | 2017-07-06 |
| 1629221395 | Joan Pietron Carlisle | Dietitian, Registered | 2121 Elm Street North, Fargo Va Medical Center, Fargo, ND 58102 | 2008-10-28 |
| 1619133832 | Mary F Larson | Dietitian, Registered | 306 4th Street North, Fargo, ND 58102-4820 | 2008-08-07 |
| 1386829844 | Jackie R Griffiths | Dietitian, Registered | 4474 23rd Ave S Ste M, Fargo, ND 58104-8795 | 2008-01-03 |
| 1437103959 | Robin J Sickels | Dietitian, Registered | 737 Broadway, Fargo, ND 58122-0001 | 2006-05-20 |
| 1881295814 | Kelsey Kincaid | Dietitian, Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-11-05 |
| 1639786742 | Sam Lucas Scardigli | Dietitian, Registered | 1600 University Dr N, Fargo, ND 58105-2502 | 2020-09-23 |
| 1710507561 | Brittany Nicole Twiss | Dietitian, Registered | 820 4th St N, Fargo, ND 58102-4539 | 2020-04-22 |
| Find all providers in FARGO | ||||
Please comment or provide details below to improve the information on MRS. MARY MONICA RUSSELL.
| 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.