Mark D Russ, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

0101051554 Issued in VA

Practice address

767 Wood Ave E
Big Stone Gap, VA 24219-3023

Phone

(276) 523-1006

Fax

(276) 523-5293

NPI assigned

Jun 7, 2006

Last updated

Mar 24, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Clinch Professional Physician Services LLC

  • Surgery Physician
  • Richlands, VA
  • NPI 1609994284

  Orthopaedic Surgery

  Medicare reassignment NPD
• Lonesome Pine Orthopaedics, PLC

  • Orthopaedic Surgery Physician
  • Big Stone Gap, VA
  • NPI 1194771212
  Authorized official Same address or phone
• Clinch Professional Physician Services LLC

  dba Clinch Valley Family Care

  • Rural Health Clinic/Center
  • Cedar Bluff, VA
  • NPI 1669157285
  NPD
• Moving Forward Physical Therapy, Inc.

  • Rehabilitation Clinic/Center
  • Pennington Gap, VA
  • NPI 1891124509
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1629018767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 857",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193366",
            "telephone_number": "276-523-1006",
            "fax_number": "276-523-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 WOOD AVE E",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193023",
            "telephone_number": "276-523-1006",
            "fax_number": "276-523-5293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101051554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010092922",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q51554",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dillon Wayne Roberts
• Allison Denise Rogers, FNP-C
• Rhonda Denise Rose
• Wendi Paige Rose
• Kirsten McKayla Ruppel
• Mindy Lee Rutherford, BS
• Jeffery Dale Sargent, MD
• Robbie D Sawyer, O.D.
• Nazrin Dixon Roberson Scott, OTR/L
• Jessica Renae Seals

• Orthopaedic Surgery Physician in Big Stone Gap, VA
• Providers in Big Stone Gap, VA by specialty
• Orthopaedic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.