Individual provider Active NPI

Michelle Russin, MD

  • Student in an Organized Health Care Education/Training Program
  • Chapel Hill, NC
National Provider Identifier
1619593605
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
2024-01267 Issued in MI
Practice address
130 Mason Farm Road Bioinformatics Building CB# 7080
Chapel Hill, NC 27599-5000
Phone
(984) 974-5050
NPI assigned
Jun 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2024-01267 MI Primary

Addresses

Primary practice location

130 Mason Farm Road Bioinformatics Building CB# 7080
Chapel Hill, NC 27599-5000

Mailing address

130 Mason Farm Road Bioinformatics Building CB# 7080
Chapel Hill, NC 27599-7080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200714000477 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2062835705
I20240907000186 NC Order and Referring Only - GastroenterologyPractitioner - Gastroenterology 2062835705

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-01267MIMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: mrussin1157941@direct.unc.nchie.net

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1619593605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MASON FARM ROAD BIOINFORMATICS BUILDING CB# 7080",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MASON FARM ROAD BIOINFORMATICS BUILDING CB# 7080",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275995000",
            "telephone_number": "984-974-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSIN",
        "first_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "2024-01267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.