Individual provider Active NPI

Joy Danae Russell, DPM

  • Podiatrist
  • Chattanooga, TN
National Provider Identifier
1215166384
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
704 Issued in TN
Practice address
5701 Brainerd Rd
Suite 111
Chattanooga, TN 37411-4016
Phone
(423) 521-8605
Fax
(423) 521-8607
NPI assigned
Jul 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 704 TN Primary

Addresses

Primary practice location

5701 Brainerd Rd
Suite 111
Chattanooga, TN 37411-4016

Mailing address

5701 Brainerd Rd
Suite 111
Chattanooga, TN 37411-4016
Phone (423) 521-8605

Other identifiers 5

IdentifierTypeStateIssuer
9862600OtherTNAETNA
8069587OtherTNCIGNA
1520824MedicaidTN
1147592OtherTNUSA MANAGED CARE
4282079OtherTNBCBS TN

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101111000993 TN Practitioner - Podiatry 3173718426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5701 Brainerd Rd
Suite 111
Chattanooga, TN 37411-4017
Phone (423) 521-8605

Hospital & facility affiliations

  • Parkridge Medical Center Hospital, Chattanooga, TN, CCN 440156

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue202
Removal of skin lesions18
Removal of nail tissue232
Removal or shaving of skin growth352

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paramount Podiatry PLLC Podiatrist CurrentSince Sep 1, 2011 Accepting new patients
Lawrence E. Burns, DPM, Inc. Past Accepting new patients

Locations

5701 Brainerd Rd
Ste 111
Chattanooga, TN 37411
Phone (423) 313-8684

5819 Winding Ln
Ste 109
Hixson, TN 37343
Phone (423) 521-8605

Organizations & group practices 2

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 1

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": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1215166384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BRAINERD RD",
            "address_2": "SUITE 111",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374114016",
            "telephone_number": "423-521-8605",
            "fax_number": "423-521-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BRAINERD RD",
            "address_2": "SUITE 111",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374114016",
            "telephone_number": "423-521-8605",
            "fax_number": "423-521-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JOY",
        "middle_name": "DANAE",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9862600",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8069587",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520824",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "1147592",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4282079",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.