Eric Brian Russell, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

E3133 Issued in AR

Practice address

2425 Dave Ward Dr
Suite 202
Conway, AR 72034-8686

Phone

(501) 328-5050

NPI assigned

Jan 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Arkansas College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Russell Dermatology of Conway, PLLCGroup PAC ID 2961528807, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

Merit-based Incentive Payment System (MIPS)

Final score

92.3 of 100Reported as group

Quality

84.61

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Russell Dermatology of Conway, PLLC

  • Dermatology Physician
  • Conway, AR
  • NPI 1639134067
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Conway Regional Medical Center Inc

  • Rural Health Clinic/Center
  • Vilonia, AR
  • NPI 1063798858

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center Inc

  • General Acute Care Hospital
  • Conway, AR
  • NPI 1497770424
  Care Compare affiliation
• Conway Regional Medical Center Inc

  • Clinical Medical Laboratory
  • Conway, AR
  • NPI 1609123017

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc

  • Family Medicine Physician
  • Russellville, AR
  • NPI 1245729359

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc

  • Psychiatry Physician
  • Conway, AR
  • NPI 1730402249

  Hospital

  Care Compare affiliation
• Conway Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Mayflower, AR
  • NPI 1851389605

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1033198510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR",
            "address_2": "SUITE 202",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348686",
            "telephone_number": "501-328-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 DAVE WARD DR",
            "address_2": "SUITE 202",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348686",
            "telephone_number": "501-328-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ERIC",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "E3133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150036001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Katherine Ruffin, RDN, LD
• Helbert Ruiz Gonzalez, MD
• Karen Joy Rush
• Russell Dermatology of Conway, PLLC
• Elana Russell, APRN
• James Bishop Russell, MD
• Richard Dewayne Russell
• Shelley W Russell, M.D.
• Sammye B Ryals, DAY TREATMENT SUPERV
• Ahmad Haythem Saadeh, MD

• Dermatology Physician in Conway, AR
• Providers in Conway, AR by specialty
• Dermatology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.