Bruce Wayne Russell, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4253 Issued in AL

Practice address

385 Bryan Rd Ste 100
Community Professional Building
Sumiton, AL 35148-3422

Phone

(205) 648-6637

Fax

(205) 648-5186

NPI assigned

Jul 4, 2006

Last updated

Jul 7, 2015By 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 AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1447280300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "SUMITON",
            "state": "AL",
            "postal_code": "351480159",
            "telephone_number": "205-648-6637",
            "fax_number": "205-648-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 BRYAN RD STE 100",
            "address_2": "COMMUNITY PROFESSIONAL BUILDING",
            "city": "SUMITON",
            "state": "AL",
            "postal_code": "351483422",
            "telephone_number": "205-648-6637",
            "fax_number": "205-648-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BRUCE",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "4253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark Allen Steele, COTA/L
• Charles Randall Stephens, CRNP
• Sumiton Discount Drug Inc
• Sumiton Family Dentistry, LLC

• General Practice Physician in Sumiton, AL
• Providers in Sumiton, AL by specialty
• General Practice Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.