Individual provider Active NPI

Russell Edwin King, MD

  • Hospitalist Physician
  • Atlanta, GA
National Provider Identifier
1619679073
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
104717 Issued in GA
Practice address
49 Jesse Jr Dr SE
Atlanta, GA 30322-1059
Phone
(404) 778-7777
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 104717 GA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

49 Jesse Jr Dr SE
Atlanta, GA 30322-1059

Mailing address

49 Jesse Jr Dr SE
Atlanta, GA 30322-0001
Phone (404) 778-7777

Other practice location 1

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 712-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260422000943 GA Practitioner - Hospitalist 5799145215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Mercer University School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104717GAMDHospitalist Physician

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1619679073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 JESSE JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220001",
            "telephone_number": "404-778-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 JESSE JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-778-7777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1364 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221059",
            "country_code": "US",
            "telephone_number": "404-712-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "RUSSELL",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "104717",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.