Christopher C Russell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9892 Issued in GA

Practice address

1 Medical Center Blvd
Cookeville, TN 38501-4294

Phone

(931) 783-2334

Fax

(931) 783-2253

NPI assigned

Jun 6, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Anycare LLC

  • Urgent Care Clinic/Center
  • Lebanon, TN
  • NPI 1780022855
  Medicare reassignment
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236
  Medicare reassignment
• Coweta Emergency Group LLC

  • Emergency Medicine Physician
  • Newnan, GA
  • NPI 1245556588
  Medicare reassignment
• Wellstreet of Georgia PC

  • Urgent Care Clinic/Center
  • Newnan, GA
  • NPI 1235411547
  Medicare reassignment
• Medical Observation Services LLC

  • Emergency Medicine Physician
  • Cookeville, TN
  • NPI 1669734877
  NPD (past)
• Volunteer Medical Group, P.C.

  • Emergency Medicine Physician
  • Cookeville, TN
  • NPI 1801886999
  NPD (past)

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1265845283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 938",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385030938",
            "telephone_number": "931-783-2334",
            "fax_number": "931-783-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014294",
            "telephone_number": "931-783-2334",
            "fax_number": "931-783-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-06",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Hannah Rubin Kunish, MS
• Vijay A Rupanagudi, MD
• Larry E Rupe, CRNA
• Scott Henry Rupe
• Brittany Danielle Rush
• Taylor Adell Russell, FNP-BC
• Brent Rogers Ryan, ATC/L
• Melissa Joy Ryglewski, B.S.
• Sunanda Sadanandan, D.O.
• Subha Saeed, M.D

• Physician Assistant in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.