Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jennifer Rae Russo, DPT

Individual provider Physical Therapist · NPI 1053644930

Jennifer Rae Russo, DPT is a Physical Therapist in Private Practice in Wilmington, North Carolina. Qualified in 2008, 18 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
18
Licensed in
NC
In the registry since
2009
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4002 1/2 Oleander Dr Ste 102
Wilmington, NC 28403-6806
Phone: (910) 216-4887
Fax: (844) 704-0649
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence P13688 (NC)

Record details

NPI number1053644930
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorYes
NPI enumeratedSeptember 10, 2009
Last updated in NPPESFebruary 18, 2026
Certification dateFebruary 18, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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