Gregg E Russell, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

001349 Issued in GA

Practice address

895 Canton Rd NE
Building 100
Marietta, GA 30060-8934

Phone

(770) 427-8111

Fax

(770) 499-1643

NPI assigned

Aug 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• M. Michael Pulliam, M.D., P.C.

  • Specialist
  • Covington, GA
  • NPI 1871635516
  NPD (past)
• Marietta Eye Clinic, PA

  • Ophthalmology Physician
  • Villa Rica, GA
  • NPI 1275221608

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487656237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 CANTON RD NE",
            "address_2": "BUILDING 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608934",
            "telephone_number": "770-427-8111",
            "fax_number": "770-499-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 CANTON RD NE",
            "address_2": "BUILDING 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608934",
            "telephone_number": "770-427-8111",
            "fax_number": "770-499-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "GREGG",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "001349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000515787W",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara T Russell, LPC
• Brittane Russell, ED.S, BCBA
• Bryan S Russell, DPM FACFAS
• Caitlin Russell, MS, RD, LD
• Cynthia Russell, LCSW
• Irving Russell, D.C.
• Lonnie Nicholas Russell, MD
• Susan F Russell, PHD,THD, L.AC.,LMSW
• Chloe Lan Russo, MD
• Diane Kay Russo, D.C.

• Optometrist in Marietta, GA
• Providers in Marietta, GA by specialty
• Optometrist in Georgia

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.