Luke Andrew Russell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5749 Issued in SC

Practice address

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896

Phone

(803) 434-1663

Fax

(803) 434-7092

NPI assigned

Oct 4, 2017

Sex

Male

Sole proprietor

No

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 OK, SC2 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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lrussell889350@direct.ghs.myhfn.org

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.

• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321
  Medicare reassignment Care Compare group NPD
• Medical Resource Management, LLC

  • Urgent Care Clinic/Center
  • Edmond, OK
  • NPI 1104056365
  Medicare reassignment
• Tulsa Emergency Medical Center Inc

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1063479087
  Medicare reassignment
• Prisma Health Medical Group-Midlands

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1407366453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012899",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036896",
            "telephone_number": "803-434-1663",
            "fax_number": "803-434-7092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7050 Air Depot Blvd Bldg 1040",
            "address_purpose": "LOCATION",
            "city": "Tinker AFB",
            "state": "OK",
            "postal_code": "731458716",
            "country_code": "US",
            "telephone_number": "405-734-2778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LUKE",
        "middle_name": "ANDREW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-04",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy L. Russell
• Crystal Miche Russell, LPC
• Dena L Russell, LISW-CP
• Emily Jean Russell
• Helen Kirby Russell, NNP
• Madyson Russell, RBT
• Nyasia Russell
• Priscilla Watts Russell, APRN
• Alex Russo
• Nicolette Paige Ruta, OD

• Physician Assistant in Columbia, SC
• Providers in Columbia, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.