NPIMap

Organization Active NPI

Russell Hospital Corporation

  • Emergency Medical Services (Emergency Medicine) Physician
  • Alexander City, AL
National Provider Identifier
1306980412
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
11873 Issued in AL
Legal business name
RUSSELL HOSPITAL CORPORATION
Practice address
3316 Highway 280
Alexander City, AL 35010-3369
Phone
(256) 329-7109
Fax
(256) 329-7617
NPI assigned
Feb 20, 2007
Last updated
Apr 28, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
RUSSELL HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Mr. Lother Peace
Title
President Ceo
Phone
(256) 329-7147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207PE0004X 11873 AL Primary

Addresses

Primary practice location

3316 Highway 280
Alexander City, AL 35010-3369

Mailing address

PO Box 939
Alexander City, AL 35011-0939
Phone (256) 329-7109

Other identifiers 2

IdentifierTypeStateIssuer
529807150MedicaidAL
558200650MedicaidAL

Other names 1

  • russell medical center physicians Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040109000579 AL Part B Supplier - Clinic/Group Practice 6406754431 Receives reassigned benefits from 41 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Goodwater, AL; Dadeville, AL; Alexander City, AL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Russelllake Martin Couns5 organizations share this tax ID, including this one
Part of
Russelllake Martin Couns

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1306980412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 939",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350110939",
            "telephone_number": "256-329-7109",
            "fax_number": "256-329-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 HIGHWAY 280",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350103369",
            "telephone_number": "256-329-7109",
            "fax_number": "256-329-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUSSELL HOSPITAL CORPORATION",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "PEACE",
        "authorized_official_first_name": "LOTHER",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "256-329-7147",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "AL",
            "license": "11873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529807150",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "558200650",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "russell medical center physicians",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Alexander City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.