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

Stacey Jo Russell, PTA

Individual provider Physical Therapy Assistant · NPI 1033462114

Stacey Jo Russell, PTA is a Physical Therapy Assistant in Riverside, Missouri. Licensed in Iowa and Missouri. Registered with an NPI since 2012.

Licensed in
IA, MO
In the registry since
2012
Specialties on file
2
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

4700 NW Cliff View Dr
Riverside, MO 64150-1237
Phone: (816) 741-5105
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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 2015030162 (MO)
Physical Therapy Assistant Taxonomy 225200000X · Licence 001388 (IA)

Record details

NPI number1033462114
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedOctober 26, 2012
Last updated in NPPESMay 25, 2020
Certification dateMay 25, 2020

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