NPIMap

Individual provider Active NPI

Megan A Russell, M.D.

  • Emergency Medicine Physician
  • Savannah, GA
National Provider Identifier
1598175861
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-11503 Issued in AR
Practice address
1107 E 66TH St
Savannah, GA 31404
Phone
(912) 350-8404
Fax
(912) 350-8067
NPI assigned
May 7, 2014
Last updated
Oct 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-11503 AR Primary
Family Medicine Physician 207Q00000X MD0000055834 TN

Addresses

Primary practice location

1107 E 66TH St
Savannah, GA 31404

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other practice location 1

2302 College Ave
Conway, AR 72034-6297
Phone (501) 329-3831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181019000062 AR Practitioner - Emergency Medicine 4486957065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faulkner Emergency Group, PLLCGroup PAC ID 1557694049, 19 clinicians

Practice addresses (Care Compare)

2302 College Ave
Conway, AR 72034-6297
Phone (501) 329-3831

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000055834TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WT University Medical Associates Inc Family Medicine Current Accepting new patients
Conway Regional Medical Center Inc Family Medicine CurrentSince Sep 15, 2018 Accepting new patients
Faulkner Emergency Group, PLLC Emergency Medicine CurrentSince May 24, 2019 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Sep 15, 2018 Accepting new patients

Locations

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

200 Corporate Blvd
Lafayette, LA 70508

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1598175861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 E 66TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31404",
            "telephone_number": "912-350-8404",
            "fax_number": "912-350-8067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2302 College Ave",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720346297",
            "country_code": "US",
            "telephone_number": "501-329-3831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MEGAN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-11503",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000055834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.