Specialists in Plastic Surgery PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SPECIALISTS IN PLASTIC SURGERY PA

Practice address

3633 Harden Rd
Ste 200
Raleigh, NC 27607-3369

Phone

(919) 785-0505

Fax

(919) 785-0205

NPI assigned

Jul 27, 2005

Last updated

Feb 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roger B Russell, MDNPI 1588668529

Title

President

Phone

(919) 785-0505

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew West Blanton, M.D.

  • Plastic Surgery Physician
  • Raleigh, NC
  • NPI 1679730907
  Medicare reassignment Care Compare group NPD
• Sanjay Venkat Daluvoy, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Raleigh, NC
  • NPI 1629395561
  Medicare reassignment Care Compare group NPD
• Roger Bivins Russell, MD

  • Plastic and Reconstructive Surgery Physician
  • Raleigh, NC
  • NPI 1588668529
  Authorized official Same address or phone
• Glenn M Davis, MD

  • Specialist
  • Raleigh, NC
  • NPI 1073794921
  NPD (past)
• William Glenn Lyle, M.D.

  • Specialist
  • Raleigh, NC
  • NPI 1700851037
  NPD (past)
• Christopher Robin Cromwell, MD

  • Plastic and Reconstructive Surgery Physician
  • Port Saint Lucie, FL
  • NPI 1629073382
  NPD (past)
• Ashley Forrest, PT, MS PT

  • Physical Therapist
  • Newport News, VA
  • NPI 1639131493
  NPD (past)

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1760482210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 HARDEN RD",
            "address_2": "STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073369",
            "telephone_number": "919-785-0505",
            "fax_number": "919-785-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 HARDEN RD",
            "address_2": "STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073369",
            "telephone_number": "919-785-0505",
            "fax_number": "919-785-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALISTS IN PLASTIC SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-27",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-785-0505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "011EM",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011EM",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline R Spear, MSW, LCSW
• Nicole Spears, PT, DPT
• Robin Spears, ITFS
• Isaiah Speas
• Joellen C Speca, M.D.
• Jonah Lee Spector, LCSWA
• Spectrum Infusion, Inc
• Spectrum Infusion, Inc
• Spectrum Medical Care, Inc.
• Spectrum Support Services

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.