Russell Paul Landry III, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

62086 Issued in TN

Practice address

651 Dunlop Lane
Clarksville, TN 37040

Phone

(713) 430-6095

NPI assigned

Mar 28, 2016

Last updated

Aug 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY, TN2 enrollments

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 2

Specialty

Emergency Medicine

Education

University of Vermont College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Services of TN, PCGroup PAC ID 3173989837, 144 clinicians

Fep of Kentucky LLCGroup PAC ID 8123473626, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Horizon Medical Center Hospital, Dickson, TN, CCN 440046
• Jennie Stuart Medical Center Hospital, Hopkinsville, KY, CCN 180051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Services of TN, PC

  • Emergency Medicine Physician
  • Nashville, TN
  • NPI 1720785884
  Medicare reassignment Care Compare group NPD
• Fep of Kentucky LLC

  • Emergency Medicine Physician
  • Hopkinsville, KY
  • NPI 1770266553
  Medicare reassignment Care Compare group NPD
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236
  Medicare reassignment NPD
• Havely Springs Emergency Group, PC

  • Emergency Medicine Physician
  • Springfield, TN
  • NPI 1770090110
  Medicare reassignment NPD
• Emergency Medicine Services of Ky, LLC

  • Emergency Medicine Physician
  • Bowling Green, KY
  • NPI 1033816194
  Medicare reassignment NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment NPD
• Ky-I Medical Services, P.S.C.

  • Physician Assistant
  • Frankfort, KY
  • NPI 1336586932
  NPD (past)

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

• Central Tennessee Hospital Corporation

  dba Tristar Horizon Medical Center

  • General Acute Care Hospital
  • Dickson, TN
  • NPI 1871530832
  Care Compare affiliation
• Jennie Stuart Medical Center Inc

  • General Acute Care Hospital
  • Hopkinsville, KY
  • NPI 1235139312
  Care Compare affiliation

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1194187179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 US HWY 127 S STE 402, BOX 367",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "40601",
            "telephone_number": "713-430-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 DUNLOP LANE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "713-430-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "RUSSELL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2023-08-02",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "51961",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "62086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2414038",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Lambert
• Jeffrey Lambert, LPC
• Toni Lamberti, PA
• Melanie Land
• Monica Ann Land
• Ashley Lane
• Kristen Elise Lane
• Edward W Laneville, CRNA
• Mary Catherine Lang, PT
• Rachel Lynn Langford, M.S., OTR/L

• Emergency Medicine Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.