Gerald Thomas Russell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD0000012638 Issued in TN

Practice address

11130 Kingston Pike
Suite 7&8
Farragut, TN 37934-2865

Phone

(865) 675-1953

NPI assigned

Oct 25, 2005

Last updated

Oct 25, 2013By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gerald.russell.1@17050.direct.athenahealth.com

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

• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Summit Medical Group, PLLC

  dba Farragut Family Practice

  • Family Medicine Physician
  • Farragut, TN
  • NPI 1073546396
  NPD
• Summit Medical Group PLLC

  dba Summit Medical Group of Oak Ridge

  • Family Medicine Physician
  • Oak Ridge, TN
  • NPI 1437238797
  NPD (past)
• Summit Medical Group,PLLC

  dba Summit Medical Group of Cookeville

  • Internal Medicine Physician
  • Cookeville, TN
  • NPI 1588362164
  NPD (past)

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382659200000",
    "number": "1043200603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "SUITE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 KINGSTON PIKE",
            "address_2": "SUITE 7&8",
            "city": "FARRAGUT",
            "state": "TN",
            "postal_code": "379342865",
            "telephone_number": "865-675-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "GERALD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2013-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000012638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "3706633",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "3706633",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31906521",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taraneh Rahmanian, PRH
• Alyssa Rivera, RDH
• Susan O Roberts, FNP
• Chandler Rosenbalm, PHARM.D.
• Melinda Ann Rudy, RDH
• Sage Dental of Farragut, PLLC
• Kristen Sharp, PHARMD
• Debra Ann Sharpe, NP-C
• David Snyder, PHARMD
• Lisa M. Spiker, DPT

• Family Medicine Physician in Farragut, TN
• Providers in Farragut, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.