Mary Russell, ACNP
NPI 1417518747 · Gerontology Nurse Practitioner · Phoenix, AZ
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mary Russell, ACNP is a Gerontology Nurse Practitioner provider in Phoenix, AZ (NPI 1417518747).
Provider details
- NPI number
- 1417518747
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- ACNP
- Sex
- Female
- Sole proprietor
- Yes
- License
- 228209 (AZ)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 7330 N 99th Ave Ste 300350Glendale, AZ 85307-3015Phone: (602) 406-0220Fax: (602) 406-0242
Registry dates
- Enumerated
- 2019-06-26
- Last updated
- 2022-03-31
- Certified
- 2022-03-31
Frequently asked questions
- What is Mary Russell's NPI number?
- Mary Russell's National Provider Identifier (NPI) is 1417518747, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mary Russell's specialty?
- Mary Russell is listed in the NPPES registry with a primary specialty of Gerontology Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Mary Russell located?
- Mary Russell's practice location on file with NPPES is 625 N 6th St, Phoenix, AZ 85004-2155.
- What is Mary Russell's phone number?
- The practice phone number listed in the NPPES registry for Mary Russell is (602) 406-8222.
- Does Mary Russell accept Medicare?
- Mary Russell is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mary Russell's NPI active?
- Yes — Mary Russell's NPI (1417518747) is active in the NPPES registry as of the last update on 2022-03-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.