Individual provider Active NPI

Marsha Yolanda Russell, MD

  • Pediatrics Physician
  • Dunn, NC
National Provider Identifier
1447569223
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2010-01505 Issued in NC
Practice address
802 Tilghman Dr
Dunn, NC 28334-5510
Phone
(910) 892-4248
Fax
(910) 892-4461
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2010-01505 NC Primary
Pediatric Infectious Diseases Physician 2080P0208X 2010-01505 NC

Addresses

Primary practice location

802 Tilghman Dr
Dunn, NC 28334-5510

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Other practice location 1

4420 Lake Boone Trl
Raleigh, NC 27607-7505
Phone (919) 784-1600

Other practice location 2

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (919) 966-7890

Other practice location 3

1301 Central Dr
Sanford, NC 27330-4159
Phone (919) 718-9512

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mrussell145521@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200331001413 NC Practitioner - Pediatric Medicine 2163851916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010-01505NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill Pediatrics CurrentSince Feb 10, 2020 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients
Unc Physicians Network LLC Pediatrics CurrentSince Mar 17, 2020 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

211 Friday Center Dr
Ste 2057
Chapel Hill, NC 27517
Phone (984) 974-1281

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

2801 Blue Ridge Rd
Raleigh, NC 27607
Phone (984) 215-6435

1301 Central Dr
Sanford, NC 27330
Phone (919) 718-9512

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1447569223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 TILGHMAN DR",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345510",
            "telephone_number": "910-892-4248",
            "fax_number": "910-892-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4420 Lake Boone Trl",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276077505",
            "country_code": "US",
            "telephone_number": "919-784-1600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144220",
            "country_code": "US",
            "telephone_number": "919-966-7890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 Central Dr",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "NC",
            "postal_code": "273304159",
            "country_code": "US",
            "telephone_number": "919-718-9512",
            "fax_number": "919-718-9516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MARSHA",
        "middle_name": "YOLANDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2010-01505",
            "primary": true
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NC",
            "license": "2010-01505",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrussell145521@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1301 Central Dr",
            "city": "Sanford",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273304159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

Verify at the official NPI Registry.