Individual provider Active NPI

Jessica Lee Russell, PA-C

  • Physician Assistant
  • Rome, GA
National Provider Identifier
1386350262
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11714 Issued in GA
Practice address
100 Three Rivers Dr NE Ste a
Rome, GA 30161-4999
Phone
(706) 292-0040
NPI assigned
Jan 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11714 GA Primary

Addresses

Primary practice location

100 Three Rivers Dr NE Ste a
Rome, GA 30161-4999

Mailing address

100 Three Rivers Dr NE Ste a
Rome, GA 30161-4999
Phone (706) 292-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230828000743 GA Practitioner - Physician Assistant 9436512241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rome Orthopaedic Center PCGroup PAC ID 9234121864, 17 clinicians

Practice addresses (Care Compare)

100 Three Rivers Dr NE
Suite a
Rome, GA 30161-4999
Phone (706) 292-0040

Hospital & facility affiliations

  • Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054
  • Adventhealth Redmond Hospital, Rome, GA, CCN 110168

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
65.74
Promoting interoperability
100
Improvement activities
40
Cost
78.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC CurrentSince Aug 7, 2023 Accepting new patients
Harbin Clinic, LLC Current Accepting new patients

Locations

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

Interoperability endpoints

  • Direct secure messaging: jessica.russell.1@1498.direct.athenahealth.com
  • Direct secure messaging: jrussell1242691@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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 2

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": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1386350262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 THREE RIVERS DR NE STE A",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614999",
            "telephone_number": "706-292-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 THREE RIVERS DR NE STE A",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614999",
            "telephone_number": "706-292-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.