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

Russell John Wareham, PTA

Individual provider Physical Therapy Assistant · NPI 1619717816

Russell John Wareham, PTA is a Physical Therapy Assistant in Indianapolis, Indiana. Licensed in Indiana. Registered with an NPI since 2024.

Licensed in
IN
In the registry since
2024
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

6002 E 38th St
Indianapolis, IN 46226-5614
Phone: (317) 880-0280
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 06002776A (IN)

Record details

NPI number1619717816
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedMay 28, 2024
Last updated in NPPESMay 28, 2024
Certification dateMay 28, 2024

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