Individual provider Active NPI

Daniel Paul Russell Jr., MD

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1184882532
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
071863 Issued in GA
Practice address
1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone
(404) 851-8000
NPI assigned
May 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 071863 GA
Diagnostic Radiology Physician 2085R0202X 071863 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606

Mailing address

5605 Glenridge Dr Ste 325
Atlanta, GA 30342-1365
Phone (678) 553-7783

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140812002287 GA Practitioner - Diagnostic Radiology 4981821196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Georgia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 662-2438

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 662-2438

1184 Nash Springs Cir
Lilburn, GA 30047-1730
Phone (404) 851-6577

220 Westminister PL
Atlanta, GA 30350-5548
Phone (404) 662-2438

3400 Old Milton Pkwy
Suite C110
Alpharetta, GA 30005-3769
Phone (404) 851-6577

758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3386
Phone (404) 662-2438

Hospital & facility affiliations

  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
96.18
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071863GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Radiology Associates LLC Neuroradiology CurrentSince Jul 7, 2014 Accepting new patients

Locations

100 Galleria Pkwy SE
Ste 1450
Atlanta, GA 30339
Phone (770) 952-8899

400 Walmart Way
Ste Fb
Dahlonega, GA 30533
Phone (706) 867-7666

1336 Highway 54 W
Bldg 500
Fayetteville, GA 30214
Phone (770) 461-1238

270 Chastain Rd NW
Kennesaw, GA 30144
Phone (678) 594-6080

758 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (770) 962-4300

5605 Glenridge Dr
Ste 325
Sandy Springs, GA 30342
Phone (678) 553-7783

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

5671 Peachtree Dunwoody Rd
Ste 160
Sandy Springs, GA 30342
Phone (404) 531-8532

Interoperability endpoints

  • Direct secure messaging: daniel.russell.1@15749.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1184882532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 GLENRIDGE DR STE 325",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421365",
            "telephone_number": "678-553-7783",
            "fax_number": "678-553-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-851-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DANIEL",
        "middle_name": "PAUL",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-31",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "GA",
            "license": "071863",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "071863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.