Active NPI
William S Russell, MD
- Pediatric Emergency Medicine (Pediatrics) Physician
- Charleston, SC
National Provider Identifier
1649267451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- TL30753
- Practice address
- 171 Ashley Ave
Charleston, SC 29425-8908 - Phone
- (843) 792-1414
- NPI assigned
- Oct 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | TL30753 | SC | Primary |
Addresses
Primary practice location
171 Ashley Ave
Charleston, SC 29425-8908
Mailing address
PO Box 751461
Charlotte, NC 28275-1461
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051527621 | Other | AL | BCBS PROVIDER NUMBER |
| 009986805 | Medicaid | AL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | wrussell20058@direct.musc.edu | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Medical College of Georgia School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.02 of 100
- Quality
- 62.41
- Promoting interoperability
- 99
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30753 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients | |
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients | |
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients |
Locations
171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123
10 McClennan Banks Dr
Charleston, SC 29401
Phone (843) 330-9824
2705 N Highway 17
#100
Mt Pleasant, SC 29466
Phone (615) 481-0418
Interoperability endpoints
- wrussell20058@direct.musc.edu
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Charleston, SC
- NPI 1043241110
-
- Obstetrics & Gynecology Physician
- Charleston, SC
- NPI 1013934629
-
- Family Medicine Physician
- Charleston, SC
- NPI 1982678496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1649267451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751461",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 ASHLEY AVE",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258908",
"telephone_number": "843-792-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "WILLIAM",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-06",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "SC",
"license": "TL30753",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "051527621",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009986805",
"state": "AL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "wrussell20058@direct.musc.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "171 Ashley Ave",
"city": "Charleston",
"state": "SC",
"country_code": "US",
"postal_code": "294258908",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.
- 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.