Organization Active NPI

Larry J Russell

Doing business as Family Medical Center

  • Family Medicine Physician
  • Hendersonville, NC
National Provider Identifier
1548234032
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LARRY J RUSSELL
Doing business as
Family Medical Center
Practice address
510 Balsam Rd
Hendersonville, NC 28792-5703
Phone
(828) 693-4431
Fax
(828) 693-4871
NPI assigned
Feb 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Laura H Ward
Title
Practice Manager
Phone
(828) 693-4431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

510 Balsam Rd
Hendersonville, NC 28792-5703

Mailing address

510 Balsam Rd
Hendersonville, NC 28792-5703
Phone (828) 693-4431

Other identifiers 2

IdentifierTypeStateIssuer
NPB019MedicaidSC
8901249MedicaidNC

Other names 1

  • Family Medical Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0916113WNC Family Medical Center, PLLC510 Balsam Road, Hendersonville, NC 28792Certificate of waiverMay 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548234032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 BALSAM RD",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287925703",
            "telephone_number": "828-693-4431",
            "fax_number": "828-693-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BALSAM RD",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287925703",
            "telephone_number": "828-693-4431",
            "fax_number": "828-693-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY J RUSSELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "828-693-4431"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPB019",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901249",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hendersonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.