NPIMap

Individual provider Active NPI

Russell Pruitt Herrington Sr., M.D.

  • Emergency Medicine Physician
  • Valley, AL
National Provider Identifier
1124048889
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31261 Issued in GA
Practice address
4800 48TH Street
Valley, AL 36854-3666
Phone
(334) 756-9180
Fax
(334) 756-5874
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 31261 GA Primary
Family Medicine Physician 207Q00000X 031261 GA

Addresses

Primary practice location

4800 48TH Street
Valley, AL 36854-3666

Mailing address

660 Snoopy Lane
Portal, GA 30450
Phone (912) 865-9353

Other identifiers 4

IdentifierTypeStateIssuer
P00400815OtherGARAILROAD MEDICARE
000400188EMedicaidGA
000400188HMedicaidGA
178575873AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110106001092 AL Practitioner - Emergency MedicinePractitioner - Family Practice 6406840974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.26 of 100Reported as group
Quality
78.94
Promoting interoperability
100
Improvement activities
40
Cost
72.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
031261GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The East Alabama Health Care Authority Current Accepting new patients
The East Alabama Health Care Authority CurrentSince Dec 1, 2015 Accepting new patients
Eamc Physicians Group Emergency Medicine CurrentSince Dec 1, 2015 Accepting new patients
East Georgia Emergency Physicians PC Past Accepting new patients
Shawmut Emergency Physicians Emergency Medicine Past Accepting new patients
Jesup Emergency Services, LLC Emergency Medicine Past Accepting new patients
Noah Tucker Inpatient Services Emergency Medicine Past Accepting new patients
East Georgia Regional Medical Center, LLC Past Accepting new patients
Screven County Family Health Center, LLC Family Medicine Past Accepting new patients
Sterling Emergency Services of the Southeast Inc Emergency Medicine Past Accepting new patients
Pea River Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

2000 Pepperell Pkwy
Opelika, AL 36801
Phone (334) 364-3300

4800 48th St
Valley, AL 36854
Phone (334) 756-1401

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.181001
  • FHIR API: https://fhir-myrecord.cerner.com/r4/c5013bf3-ebba-4bda-8574-ed83da9e1633/

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1124048889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 SNOOPY LANE",
            "city": "PORTAL",
            "state": "GA",
            "postal_code": "30450",
            "telephone_number": "912-865-9353",
            "fax_number": "912-865-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 48TH STREET",
            "city": "VALLEY",
            "state": "AL",
            "postal_code": "368543666",
            "telephone_number": "334-756-9180",
            "fax_number": "334-756-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRINGTON",
        "first_name": "RUSSELL",
        "middle_name": "PRUITT",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "31261",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "031261",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD  MEDICARE",
            "identifier": "P00400815",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000400188E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000400188H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178575873A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley, AL

Sources for this page

Verify at the official NPI Registry.