Individual provider Active NPI

Jessica Brannon Russell, M.D.

  • Obstetrics & Gynecology Physician
  • Annapolis, MD
National Provider Identifier
1447397583
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D0068757 Issued in MD
Practice address
2000 Medical Pkwy Ste 306
Annapolis, MD 21401-3745
Phone
(410) 571-9700
Fax
(410) 571-9710
NPI assigned
Jan 30, 2007
Last updated
Dec 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D0068757 MD Primary

Addresses

Primary practice location

2000 Medical Pkwy Ste 306
Annapolis, MD 21401-3745

Mailing address

2000 Medical Pkwy Ste 306
Annapolis, MD 21401-3745
Phone (410) 980-3729

Other identifiers 1

IdentifierTypeStateIssuer
D0068757OtherMDMEDICAL LICENSE

Other names 1

  • Dr. Jessica Katherine Brannon Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Annapolis Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101230000193 MD Practitioner - Obstetrics/Gynecology 7517155831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Virginia Commonwealth University, School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

133 Defense Hwy
Annapolis, MD 21401-7015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Obstetrics & Gynecology Current Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 21, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 21, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Chesapeake Women's Care, P.a. Past Accepting new patients
Medical Associates of Central Virginia, Inc. Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

2000 Medical Pkwy
Ste 306
Annapolis, MD 21401
Phone (410) 571-9700

2401 Brandermill Blvd
Ste 310
Gambrills, MD 21054
Phone (410) 451-7952

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jessica.russell.1@8042.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1447397583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY STE 306",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013745",
            "telephone_number": "410-980-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY STE 306",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013745",
            "telephone_number": "410-571-9700",
            "fax_number": "410-571-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JESSICA",
        "middle_name": "BRANNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0068757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "D0068757",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Annapolis",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2000 Medical Pkwy Ste 306",
            "city": "Annapolis",
            "state": "MD",
            "country_code": "US",
            "postal_code": "214013745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BRANNON",
            "middle_name": "KATHERINE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.