NPIMap

Individual provider Active NPI

Bethany Russell, M.D.

  • Family Medicine Physician
  • Paris, TN
National Provider Identifier
1710371117
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55361 Issued in TN
Practice address
1323 E Wood St
Paris, TN 38242
Phone
(731) 642-2011
Fax
(731) 644-2758
NPI assigned
Mar 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 55361 TN Primary

Addresses

Primary practice location

1323 E Wood St
Paris, TN 38242

Mailing address

1323 E Wood St
Paris, TN 38242-4421
Phone (731) 642-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181023003077 TN Practitioner - Family Practice 5890008460 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Tennessee, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Wood Clinic PLLCGroup PAC ID 0143249839, 5 clinicians

Practice addresses (Care Compare)

1009 N Locust Ave
Lawrenceburg, TN 38464-2746
Phone (571) 982-6636

1323 E Wood St
Paris, TN 38242-4421
Phone (731) 642-2011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.84 of 100Reported as apm
Quality
69.69
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55361TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Wood Clinic PLLC Family Medicine CurrentSince Aug 1, 2018 Accepting new patients
Privia Medical Group Tennessee LLC CurrentSince Jan 20, 2026 Accepting new patients
Privia Medical Group Tennessee LLC Family Medicine CurrentSince Jan 20, 2026 Accepting new patients

Locations

1009 N Locust Ave
Lawrenceburg, TN 38464
Phone (931) 244-7181

1323 E Wood St
Paris, TN 38242
Phone (731) 642-2011

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20938/brand/1/csg/1/fhir/r4
  • Direct secure messaging: brussell@ewc.gwaydirect.com
  • Direct secure messaging: bethany.russell.1@20938.direct.athenahealth.com

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1710371117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 E WOOD ST",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "382424421",
            "telephone_number": "731-642-2011",
            "fax_number": "731-644-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 E WOOD ST",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "38242",
            "telephone_number": "731-642-2011",
            "fax_number": "731-644-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BETHANY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "55361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TN

Sources for this page

Verify at the official NPI Registry.