SAMUEL DAVID RUSSO RDN
NPI 1912886375
Dietitian, Registered in Des Peres, MO

Active since August 29, 2025
13100 MANCHESTER RD STE 175, DES PERES, MO 63131(314) 275-0658 Get Directions Write a Review

NPPES record last updated: August 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Samuel David Russo Rdn NPPES

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

SAMUEL DAVID RUSSO RDN (NPI 1912886375) is an individual dietitian, registered in Des Peres, Missouri, licensed in Missouri (86436000) and active in the NPI registry since August 2025.

NPPES Registry Identity

NPI1912886375
Entity TypeIndividualMale
Primary Taxonomy133V00000X
Provider Legal NameSAMUEL DAVID RUSSOCredential: RDN
Location Address13100 MANCHESTER RD STE 175Des Peres, MO 63131-1729
Mailing Address13100 Manchester Rd Ste 175Des Peres, MO 63131-1729 · (314) 275-0658
Sole ProprietorNo
Enumeration DateAugust 29, 2025
NPPES CertifiedAugust 29, 2025
NPI 1912886375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License Licensed in MO · 86436000
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
13100 MANCHESTER RD STE 175, Des Peres, MO 63131

Other Providers at the Same Location NPPES 4

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

Dietitian, Registered
13100 MANCHESTER RD STE 175
DES PERES, MO 63131
Dietitian, Registered
13100 MANCHESTER RD STE 175
SAINT LOUIS, MO 63131
Nutritionist
13100 MANCHESTER RD STE 175
DES PERES, MO 63131
Dietitian, Registered
13100 MANCHESTER RD STE 175
DES PERES, MO 63131

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 Samuel Russo's NPI number?

The NPI number for Samuel Russo is 1912886375. It was assigned to this individual provider in the NPPES registry on August 29, 2025.

Where is Samuel Russo located?

Samuel Russo practices at 13100 Manchester Rd Ste 175, Des Peres, MO 63131. The listed phone number is (314) 275-0658.

What is Samuel Russo's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

When was this NPI record last updated?

The NPPES record for Samuel Russo was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.