NPIMap

Individual provider Active NPI

Russell Darren Lendermon, M.D.

  • Emergency Medicine Physician
  • Grovetown, GA
National Provider Identifier
1184885816
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
003122 Issued in GA
Practice address
3204 Sweet Meadow CT
Grovetown, GA 30813-8108
Phone
(501) 605-6186
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 003122 GA Primary

Addresses

Primary practice location

3204 Sweet Meadow CT
Grovetown, GA 30813-8108

Mailing address

3204 Sweet Meadow CT
Grovetown, GA 30813-8108
Phone (501) 605-6186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20110811000601 AR Practitioner - Emergency Medicine 5698944452 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arkansas College of Medicine, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Unity Health - JacksonvilleGroup PAC ID 8325418882, 18 clinicians
White County Medical CenterGroup PAC ID 4880688654, 182 clinicians

Practice addresses (Care Compare)

1400 Braden St
Jacksonville, AR 72076-3721
Phone (501) 380-3172

3214 E Race Ave
Searcy, AR 72143-4810
Phone (501) 380-1010

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
White County Medical Center CurrentSince Jul 7, 2011 Accepting new patients
Unity Health - Newport Emergency Medicine CurrentSince Dec 26, 2023 Accepting new patients
White County Medical Center Emergency Medicine CurrentSince Jul 7, 2011 Accepting new patients
Unity Health - Newport Current Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Oct 25, 2016 Accepting new patients
Unity Health - Jacksonville Emergency Medicine CurrentSince Jan 20, 2024 Accepting new patients
Unity Health - Newport CurrentSince Dec 26, 2023 Accepting new patients

Locations

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1400 Braden St
Little Rock AFB, AR 72076
Phone (501) 380-3172

1117 McLain St
Ste 500
Newport, AR 72112
Phone (870) 523-6464

1205 McLain St
Newport, AR 72112
Phone (870) 512-3441

3214 E Race Ave
Searcy, AR 72143
Phone (501) 268-6121

2900 Hawkins Dr
Searcy, AR 72143
Phone (501) 278-2800

Organizations & group practices 7

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1184885816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 SWEET MEADOW CT",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308138108",
            "telephone_number": "501-605-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 SWEET MEADOW CT",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308138108",
            "telephone_number": "501-605-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENDERMON",
        "first_name": "RUSSELL",
        "middle_name": "DARREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "003122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grovetown, GA

Sources for this page

Verify at the official NPI Registry.