NPIMap

Individual provider Active NPI

Joshua Daniel Russ, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1184961633
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3623 Latrobe Dr
Suite 216
Charlotte, NC 28211-4864
Phone
(704) 332-1291
Fax
(704) 332-5206
NPI assigned
Jan 3, 2013
Last updated
Jan 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

3623 Latrobe Dr
Suite 216
Charlotte, NC 28211-4864

Mailing address

PO Box 221249
Charlotte, NC 28222-1249
Phone (704) 332-1291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130306000301 NC Practitioner - Physician Assistant 9638324163 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians
Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

Statesville, NC 28677
Phone (704) 838-2182

136 E 36TH St
Suite 200
Charlotte, NC 28206-2018
Phone (704) 801-3400

1540 E Broad St
Statesville, NC 28625-4302

16645 Birkdale Commons Pkwy
Suite 100
Huntersville, NC 28078-5669
Phone (704) 801-7390

20036 Zion Ave
Suite 100
Cornelius, NC 28031-8435
Phone (704) 801-7400

3193 W Hwy 74
Monroe, NC 28110-8437
Phone (704) 698-4089

409 Olin Way
Suite 1200
Denver, NC 28037-9250
Phone (704) 801-7320

4525 Cameron Valley Pkwy
Suite 4100D
Charlotte, NC 28211-4369
Phone (980) 402-1800

653 Bluefield Rd
Mooresville, NC 28117-9626

728 Hartness Rd
Statesville, NC 28677-3425
Phone (704) 380-6420

766 Hartness Rd
Suite B
Statesville, NC 28677-3479

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Dec 20, 2025 Accepting new patients
Iredell Physician Network LLC CurrentSince May 1, 2022 Accepting new patients
Iredell Physician Network, LLC CurrentSince May 1, 2022 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 20, 2025 Accepting new patients
Iredell Physician Network LLC Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

3193 W Highway 74
Monroe, NC 28110
Phone (704) 689-4089

653 Bluefield Rd
Ste A
Mooresville, NC 28117
Phone (704) 360-6460

1540 E Broad St
Statesville, NC 28625
Phone (704) 230-4382

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

Interoperability endpoints

  • Direct secure messaging: jruss1231117@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1184961633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221249",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282221249",
            "telephone_number": "704-332-1291",
            "fax_number": "704-332-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 LATROBE DR",
            "address_2": "SUITE 216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114864",
            "telephone_number": "704-332-1291",
            "fax_number": "704-332-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "JOSHUA",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-03",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.