Kimberly Ann Russell, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36903 Issued in TN

Practice address

300 Laboratory Rd
Oak Ridge, TN 37830

Phone

(865) 482-7698

NPI assigned

Jun 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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

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 and National Provider Directory roles.

• Summit Medical Group, PLLC

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Cogent Healthcare of Tennessee, PC

  • Internal Medicine Physician
  • Dyersburg, TN
  • NPI 1952654246
  NPD
• Summit Medical Group, PLLC

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1275824658
  NPD
• National Health Corporation

  • Skilled Nursing Facility
  • Oak Ridge, TN
  • NPI 1598703076
  NPD (past)
• NHC Healthcare-Athens LLC

  • Skilled Nursing Facility
  • Athens, TN
  • NPI 1316992274
  NPD (past)
• NHC Healthcare-Knoxville LLC

  • Skilled Nursing Facility
  • Knoxville, TN
  • NPI 1750306759
  NPD (past)
• Parkwest Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  NPD (past)
• Renuven Health Partners of Georgia PC

  • Internal Medicine Physician
  • Fort Oglethorpe, GA
  • NPI 1871196519
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1194753293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 EAST OAKLAND AVENUE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011843",
            "telephone_number": "423-926-2358",
            "fax_number": "423-926-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LABORATORY RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "37830",
            "telephone_number": "865-482-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "36903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3885411",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00040818",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Rundle
• Caleb Runne, D.C.
• Lea Anna Rushing, COTA/L
• Afton RZ Russell
• Gyles Donald Russell, PT
• Dana Rust
• James Peter Ruyl, DDS
• Cinda S Sagnes, PHD LCSW
• Kristen Salyards, NP
• Jennifer Sampson, FNP-C

• Internal Medicine Physician in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.