Individual provider Active NPI

Russell Edward Buss, M.D.

  • Emergency Medicine Physician
  • Clyde, NC
National Provider Identifier
1679509756
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
9500526 Issued in NC
Practice address
262 Leroy George Dr
Clyde, NC 28721-7430
Phone
(828) 452-8110
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 9500526 NC Primary

Addresses

Primary practice location

262 Leroy George Dr
Clyde, NC 28721-7430

Mailing address

747 Coyote Hollow Rd
Waynesville, NC 28785-6524
Phone (828) 627-3187

Other identifiers 1

IdentifierTypeStateIssuer
8912014MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20171027000336 KY Practitioner - Emergency Medicine 6608866462 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9500526NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Medical Partners, LLC Emergency Medicine CurrentSince Jun 15, 2021 Accepting new patients
Concord Medical Group of Kentucky PLLC Emergency Medicine CurrentSince Feb 1, 2024 Accepting new patients
Middlesborough Emergency Physicians LLC Emergency Medicine CurrentSince Sep 22, 2017 Accepting new patients
Western Healthcare Services Kentucky LLC Emergency Medicine CurrentSince Jan 24, 2022 Accepting new patients
Centra Health Inc Past Accepting new patients
Southside Community Hospital, Inc. Past Accepting new patients
Clyde Emergency Solutions LLC Emergency Medicine Past Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients
Martha Jefferson Hospital Past Accepting new patients
Virginia Emergency Group LLC Emergency Medicine Past Accepting new patients

Locations

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

309 11th St
Carrollton, KY 41008
Phone (502) 732-3241

1011 Old Highway 60
Hardinsburg, KY 40143
Phone (270) 756-7000

3600 Cumberland Ave
Middlesboro, KY 40965
Phone (606) 237-1700

Organizations & group practices 10

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1679509756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 COYOTE HOLLOW RD",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287856524",
            "telephone_number": "828-627-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 LEROY GEORGE DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287217430",
            "telephone_number": "828-452-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSS",
        "first_name": "RUSSELL",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9500526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912014",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

Verify at the official NPI Registry.