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CONNIE RUSSELL
NPI 1518509637
Nurse Practitioner - Family in Salt Lake City, UT

Active since October 09, 2019PECOS Enrolled
1205 E BONNER WAY, SALT LAKE CITY, UT 84117(801) 598-8337 Get Directions Write a Review

NPPES record last updated: October 15, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 15, 2020, Oct 9, 2019 (2 updates tracked since 2019).

About Connie Russell NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNIE RUSSELL (NPI 1518509637) is an individual family provider in Salt Lake City, Utah, licensed in Utah (366691-4405) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1518509637
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameCONNIE RUSSELL
Location Address1205 E BONNER WAYSalt Lake City, UT 84117-4917
Mailing Address9091 S Excaliber WayWest Jordan, UT 84088-6583 · (801) 824-7406
Phone(801) 598-8337
Sole ProprietorYes
Enumeration DateOctober 9, 2019
Last NPPES UpdateOctober 15, 20202 updates tracked since enumeration
NPPES CertifiedOctober 15, 2020
✔ NPI 1518509637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 366691-4405
Also ListedRegistered NurseTaxonomy 163W00000X · License 366691-3102 (UT)
1205 E BONNER WAY, Salt Lake City, UT 84117
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Connie Russell is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers21 claims21 services$184.46 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHELBY JANE STEFFENSEN
Recreation Therapist
1205 E BONNER WAY
MILLCREEK, UT 84117
Salt Lake County (801) 262-2908
KENADEE GROBERG
Recreational Therapist Assistant
1205 E BONNER WAY
MILLCREEK, UT 84117
Salt Lake County (801) 262-2908

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Connie Russell's NPI number?

The NPI number for Connie Russell is 1518509637. It was assigned to this individual provider in the NPPES registry on October 9, 2019.

Where is Connie Russell located?

Connie Russell practices at 1205 E Bonner Way, Salt Lake City, UT 84117. The listed phone number is (801) 598-8337.

What is Connie Russell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Connie Russell enrolled in Medicare?

Yes. Connie Russell is registered in the Medicare PECOS enrollment system.

What insurance does Connie Russell accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Utah list Connie Russell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Connie Russell was last updated on October 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.