Lauren H Russell, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9747 Issued in GA

Practice address

3903 S Cobb Dr SE Ste 200
Smyrna, GA 30080-6301

Phone

(770) 435-3214

NPI assigned

Jun 9, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cobb Medical Associates, LLC

  • Family Medicine Physician
  • Smyrna, GA
  • NPI 1831277987

  Medical

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1023633799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 S COBB DR SE STE 200",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806301",
            "telephone_number": "770-435-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 S COBB DR SE STE 200",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806301",
            "telephone_number": "770-435-3214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12614 Sandburg Ln",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379226725",
            "country_code": "US",
            "telephone_number": "478-955-8316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LAUREN",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "9747",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith T Rott, M.D.
• Dominique Cierra Rowe, WHNP-BC
• George Rowe, PSYO
• Tod Rubin, DO
• Kelsie Rushlow
• RV Behavioral, LLC
• Brett M Ryabik, MD
• Anne Sabo, MED, CBS
• Oluwaseun Christiannah Sadare, MD
• Saint Joseph'S Mercy Care Services, Inc.

• All providers in Smyrna, GA
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.