Samuel Russell, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

30117 Issued in TN

Practice address

6740 Lee Hwy
Chattanooga, TN 37421-2423

Phone

(423) 553-9394

Fax

(423) 553-9398

NPI assigned

Nov 30, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Liberty Healthcare Partners

  • General Practice Physician
  • Chattanooga, TN
  • NPI 1003529280
  NPD
• Sentef Medical Center

  • Clinic/Center
  • Ooltewah, TN
  • NPI 1043418742
  NPD

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1043978844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6740 LEE HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212423",
            "telephone_number": "423-553-9394",
            "fax_number": "423-553-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6740 LEE HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212423",
            "telephone_number": "423-553-9394",
            "fax_number": "423-553-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SAMUEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheyanne Russell
• Joy Danae Russell, DPM
• Kathryn Ann Russell, MS, RDN, LD
• Leandra Russell
• Paige Noelle Russell, APRN
• Timothy Lynn Russell, LMT
• Katherine Rustand, M.ED
• Bailey Gregory Ryabchuk, BCBA
• Daley Ryan, M.S., LPC-MHSP
• Eugene H Ryan, MD

• Family Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.