MARY ELIZABETH RUSSOM
NPI 1902630510
Technician - Personal Care Attendant in Logan, WV

Q: What is Mary Russom's NPI number?

The NPI number for Mary Russom is 1902630510. It was assigned to this individual provider in the NPPES registry on August 27, 2024.

Q: What is Mary Russom's specialty?

The primary specialty registered for this NPI is Technician, specializing in Personal Care Attendant, with taxonomy code 3747P1801X.

Q: When was this NPI record last updated?

The NPPES record for Mary Russom was last updated on August 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.

Active since August 27, 2024

164 SUNBEAM RD, LOGAN, WV 25601(304) 733-1094 Get Directions Write a Review

NPPES record last updated: August 27, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mary Elizabeth Russom NPPES

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

MARY ELIZABETH RUSSOM (NPI 1902630510) is an individual personal care attendant in Logan, West Virginia and active in the NPI registry since August 2024.

NPPES Registry Identity

NPI1902630510

Entity TypeIndividualFemale

Primary Taxonomy3747P1801X

Provider Legal NameMARY ELIZABETH RUSSOM

Location Address164 SUNBEAM RDLogan, WV 25601-1310

Mailing Address164 Sunbeam RdLogan, WV 25601-1310

Phone(304) 733-1094

Sole ProprietorNo

Enumeration DateAugust 27, 2024

NPPES CertifiedAugust 27, 2024

✔ NPI 1902630510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician · Personal Care AttendantNursing Service Related Providers

Taxonomy Code3747P1801X

Definition

An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards

164 SUNBEAM RD, Logan, WV 25601

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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.

MACIE FAITH FRYE

Technician (Personal Care Attendant)

164 SUNBEAM RD
LOGAN, WV 25601

Logan County (304) 733-1094

COREY DILLAN JOHNSON

Technician (Personal Care Attendant)

164 SUNBEAM RD
LOGAN, WV 25601

Logan County (681) 583-0480

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 Mary Russom's NPI number?

The NPI number for Mary Russom is 1902630510. It was assigned to this individual provider in the NPPES registry on August 27, 2024.

Where is Mary Russom located?

Mary Russom practices at 164 Sunbeam Rd, Logan, WV 25601. The listed phone number is (304) 733-1094.

What is Mary Russom's specialty?

The primary specialty registered for this NPI is Technician, specializing in Personal Care Attendant, with taxonomy code 3747P1801X.

When was this NPI record last updated?

The NPPES record for Mary Russom was last updated on August 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.