Active NPI
Russell Merrittt Hostetler, M.D.
- Family Medicine Physician
- Tampa, FL
National Provider Identifier
1508132762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME 60537
- Practice address
- 2514 W Virginia Ave
Tampa, FL 33607-6326 - Phone
- (813) 877-1370
- NPI assigned
- Mar 31, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME 60537 | FL | Primary |
| Family Medicine Physician | 207Q00000X | MD 30287 | SC | |
| Family Medicine Physician | 207Q00000X | D0069526 | MD | |
| Family Medicine Physician | 207Q00000X | 20137 | MS |
Addresses
Primary practice location
2514 W Virginia Ave
Tampa, FL 33607-6326
Mailing address
2514 W Virginia Ave
Tampa, FL 33607-6326
Phone (813) 877-1370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 60537 | FL | MD | Family Medicine Physician |
| D0069526 | MD | MD | Family Medicine Physician |
| 20137 | MS | MD | Family Medicine Physician |
| MD 30287 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1508132762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2514 W VIRGINIA AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336076326",
"telephone_number": "813-877-1370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2514 W VIRGINIA AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336076326",
"telephone_number": "813-877-1370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOSTETLER",
"first_name": "RUSSELL",
"middle_name": "MERRITTT",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-31",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME 60537",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "MD 30287",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D0069526",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "20137",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.