Thomas Gerald Russell Jr., M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

27843 Issued in KY

Practice address

1099 Medical Center Cir
Mayfield, KY 42066-1159

Phone

(270) 251-4242

Fax

(270) 251-4240

NPI assigned

Mar 14, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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 1

Specialty

Emergency Medicine

Education

University of Mississippi School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Fairview Emergency Physicians LLCGroup PAC ID 5799034799, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Fairview Emergency Physicians LLC

  • Emergency Medicine Physician
  • Ashland, KY
  • NPI 1578060331
  Medicare reassignment Care Compare group NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382
  Medicare reassignment NPD
• Marshall Emergency Services Associates, PLLC

  • Emergency Medicine Physician
  • Lexington, KY
  • NPI 1891737185
  NPD (past)
• Western Baptist Medical Ventures, Inc.

  dba Paducah Neurosurgical Center

  • Neurological Surgery Physician
  • Paducah, KY
  • NPI 1316017080
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  Care Compare affiliation

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417080631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 STATE ROUTE 2205",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420664886",
            "telephone_number": "270-247-9601",
            "fax_number": "270-247-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661159",
            "telephone_number": "270-251-4242",
            "fax_number": "270-251-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "THOMAS",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "27843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L. Byars, Jr.
• Paul E. Robertson, O.D.
• Rollins Bedford Corporation (Mills Manor Nursing Home)
• Amanda Rosales Rowe, CERTIFIED MSW
• Mandela Rudd, RD, LD, LDE
• S.E.W. Enterprises, Inc. (Duncan Prescription Center)
• S.E.W. Enterprises, Inc. (Duncan Prescription Center)
• S.E.W. Enterprises, Inc. (Duncan Clinic Pharmacy)
• S.E.W. Enterprises, Inc. (Duncan Specialty Pharmacy)
• James Savage, PH.D.

• Emergency Medicine Physician in Mayfield, KY
• Providers in Mayfield, KY by specialty
• Emergency Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.