Dawn Marie Russell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.003959 Issued in OH

Practice address

4881 Sugar Maple Dr
88TH Medical Group
Wright Patterson AFB, OH 45433-5250

Phone

(937) 257-1941

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Melissa Gargasz Urgent Care LLCGroup PAC ID 7315253325, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Dr Melissa Gargasz Urgent Care LLC

  dba Waynesville Urgent Care

  • Urgent Care Clinic/Center
  • Waynesville, OH
  • NPI 1184008070
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1508906116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7392 FOXDALE DR",
            "city": "WAYNESVILLE",
            "state": "OH",
            "postal_code": "450688200",
            "telephone_number": "513-855-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "address_2": "88TH MEDICAL GROUP",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335250",
            "telephone_number": "937-257-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "1076380",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110474",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirk Lee Rowe, PH.D.
• Aaron Rubin, M.D.
• Margaret Maureen Rueger, PHARMD
• Samantha Ruffe, MD
• David Christopher Rupp, D.D.S.
• Lillian Sai
• Maria Domingo Santos, DDS
• Jessica Sathissarat
• Lori Saturley, RDH
• Paul E Savard, PA-C

• Physician Assistant in Wright Patterson AFB, OH
• Providers in Wright Patterson AFB, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.