MRS. HOLLY ROXANNE RUSSELL (DPT) – Physical Therapist, NPI 1689673410
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,028 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IL
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Provider Addresses for MRS. HOLLY ROXANNE RUSSELL (DPT)
720 COUNTY ROAD 1435 N
CARMI, IL 628214827
Phone: (618) 382-3986
Fax: (618) 382-3986
Type: Mailing
2907, Williamson County Parkway, Marion, Williamson County, Illinois, 62959, United States
MARION, IL 629595256
Phone: (618) 998-9894
Fax: (618) 998-9993
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-01-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040123000931 | I | Physical Therapist In Private Practice | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62821)
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Group practice members
- 1
- 2
- 3
- 4
- 5
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| - | AL | |
| - | IL | |
| Qualified Speech Language Pathologist | FL | |
| - | MO | |
| Occupational Therapist In Private Practice | UT | |
| Physical Therapist In Private Practice | WI | |
| - | WI | |
| - | WI | |
| - | FL |
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