Individual provider Active NPI

Brett Russell, MD

  • Pediatric Critical Care Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1275042384
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME176643 Issued in FL
Practice address
807 Childrens Way
Jacksonville, FL 32207-8426
Phone
(904) 697-3600
NPI assigned
Sep 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X ME176643 FL Primary

Addresses

Primary practice location

807 Childrens Way
Jacksonville, FL 32207-8426

Mailing address

807 Childrens Way
Jacksonville, FL 32207-8426
Phone (904) 697-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20210729003928 MD Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 8527317528 Reassigns benefits to 2 organizations
I20211115001583 DC Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 8527317528 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C7-0018170DEMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WHC Emerg Phys CurrentSince Nov 1, 2021 Accepting new patients
Mep Health, LLC CurrentSince Jul 1, 2021 Accepting new patients
WHC Physician Group LLC CurrentSince Nov 1, 2021 Accepting new patients
Bethesda Emergency Associates LLC Past Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

2401 W Belvedere Ave
Baltimore, MD 21215

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

Interoperability endpoints

  • Direct secure messaging: brussell736612@direct.hopkinsmedicine.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1275042384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 CHILDRENS WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078426",
            "telephone_number": "904-697-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 CHILDRENS WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078426",
            "telephone_number": "904-697-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME176643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.