William A Russell III, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

33464 Issued in NC

Practice address

1905 Glen Meade Rd
Wilmington, NC 28403-6024

Phone

(910) 763-6251

Fax

(910) 763-7408

NPI assigned

Jul 28, 2005

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: williamrussell@uasnc.allscriptsdirect.net

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1689674954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036024",
            "telephone_number": "910-763-6251",
            "fax_number": "910-763-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 GLEN MEADE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036024",
            "telephone_number": "910-763-6251",
            "fax_number": "910-763-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "33464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8974046",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Lynn Russell-Ladd, FNP
• Christopher Russell
• Grace Ellen Russell
• Karen M Russell, PAC
• Marissa Leigh Russell
• Jennifer Rae Russo, DPT
• Sabrina Russo, RDN
• Jerry Page Rutledge, LCSW
• Brandi Elizabeth Ryan, LMT
• Brandon Ryan, PA-C, NREMT-P

• Specialist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.