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DR. KATHLEEN F RUSSO M.D.
NPI 1558452532
Pediatrics - Adolescent Medicine in Salisbury, NC

Active since September 27, 2006Opted out of Medicare · through Dec 28, 2027
129 WOODSON ST, SALISBURY, NC 28144(704) 636-5576(704) 636-1755 Get Directions Write a Review

NPPES record last updated: July 11, 2013. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Dr. Kathleen F Russo M.d. NPPES

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

DR. KATHLEEN F RUSSO M.D. (NPI 1558452532) is an individual adolescent medicine provider in Salisbury, North Carolina, licensed in North Carolina (9700384) and active in the NPI registry since September 2006. She has opted out of Medicare through December 28, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1558452532
Entity TypeIndividualFemale
Primary Taxonomy2080A0000X
Provider Legal NameDR. KATHLEEN F RUSSOCredential: M.D.
Location Address129 WOODSON STSalisbury, NC 28144-3255
Mailing Address129 Woodson StSalisbury, NC 28144-3255 · (704) 636-5576 · Fax (704) 636-1755
Phone(704) 636-5576
Fax(704) 636-1755
Sole ProprietorNo
Enumeration DateSeptember 27, 2006
Last NPPES UpdateJuly 11, 2013
✔ NPI 1558452532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in NC · 9700384
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X · License 9700384 (NC)
Also ListedPediatricsTaxonomy 208000000X · License 9700384 (NC)
Also ListedPediatrics · Child Abuse PediatricsTaxonomy 2080C0008X · License 9700384 (NC)
129 WOODSON ST, Salisbury, NC 28144
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Other Identifiers 10

Medicare UPING48100
Other1241179NC · United Healthcare
Other1032HNC · Bcbs
Other20522NC · Partners
Other72589NC · Medcost Preferred
Other560988747NC · Cigna Healthcare
Other8382976NC · Aetna
Other413263NC · Phcs
Medicaid891032HNC
Other284339NC · Mamsi

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kathleen F Russo M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 28, 2015 through December 28, 2027.

Opt-Out Effective DateDecember 28, 2015
Opt-Out In Effect ThroughDecember 28, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

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

DR. WAYNE CARSON KOONTZ M.D.
Pediatrics (Adolescent Medicine)
129 WOODSON ST
SALISBURY, NC 28144
Rowan County (704) 636-5576
CMC-NORTHEAST, INC
Pediatrics (Pediatric Pulmonology)
129 WOODSON ST, SUITE D
SALISBURY, NC 28144
Rowan County (704) 403-2660
AUBRIE NORRIS CORNELIUS N.P.
Nurse Practitioner (Pediatrics)
129 WOODSON ST
SALISBURY, NC 28144
Rowan County (704) 636-5576
CMC-NORTHEAST, INC.
Pediatrics (Pediatric Critical Care Medicine)
129 WOODSON ST, SUITE A
SALISBURY, NC 28144
Rowan County (704) 403-2660
MANDY BLAKE PNP
Nurse Practitioner (Pediatrics)
129 WOODSON ST
SALISBURY, NC 28144
Rowan County (704) 636-5576
MARTHA PUGA I.B.C.L.C.
Registered Nurse (Lactation Consultant)
129 WOODSON ST
SALISBURY, NC 28144
Rowan County (704) 636-5576
VICTORIA KATHERINE BOYLES FNP-C
Nurse Practitioner (Family)
129 WOODSON ST
SALISBURY, NC 28144
Rowan County (704) 636-5576
LINDSAY MORGAN LYKE PA-C
Physician Assistant
129 WOODSON ST
SALISBURY, NC 28144
Rowan County (704) 636-5576

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 Kathleen Russo's NPI number?

The NPI number for Kathleen Russo is 1558452532. It was assigned to this individual provider in the NPPES registry on September 27, 2006.

Where is Kathleen Russo located?

Kathleen Russo practices at 129 Woodson St, Salisbury, NC 28144. The listed phone number is (704) 636-5576.

What is Kathleen Russo's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Kathleen Russo enrolled in Medicare?

No. Kathleen Russo has opted out of Medicare through December 28, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kathleen Russo was last updated on July 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.