PMR Retailer LLC

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

PMR RETAILER LLC

Practice address

13 Ray Rd
Covington, GA 30014-5954

Phone

(470) 205-9882

NPI assigned

Apr 14, 2026

Organization subpart

No

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

Authorized official

Name

Pamela Mechelle Russell, AAS, OVC/NOVANPI 1194668731

Title

Owner

Phone

(470) 205-9882

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pamela Mechelle Russell

  • Case Manager/Care Coordinator
  • Covington, GA
  • NPI 1194668731

  Case Management

  NPD Authorized official

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

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1770426504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 RAY RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300145954",
            "telephone_number": "470-205-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 RAY RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300145954",
            "telephone_number": "470-205-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMR RETAILER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "MECHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-205-9882",
        "authorized_official_credential": "AAS, OVC/NOVA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristen Elizabeth Poteracki, MSN, APRN, FNP-C

• Supports Brokerage Agency in Covington, GA
• Providers in Covington, GA by specialty
• Supports Brokerage Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; 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.