NPIMap

Individual provider Active NPI

Russell H G Louis Jr., MD

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1790745701
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25081 Issued in SC
Practice address
316 Calhoun St
Charleston, SC 29401-1113
Phone
(843) 724-2010
Fax
(843) 724-2005
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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 25081 SC Primary

Addresses

Primary practice location

316 Calhoun St
Charleston, SC 29401-1113

Mailing address

PO Box 601495
Charlotte, NC 28260-1495
Phone (843) 789-1620

Other identifiers 1

IdentifierTypeStateIssuer
250819MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20050720000178 SC Practitioner - Emergency Medicine 0143257378 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Louisville School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broad River Physicians Group, LLCGroup PAC ID 8123385143, 70 clinicians

Practice addresses (Care Compare)

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

Hospital & facility affiliations

  • Roper Hospital Hospital, Charleston, SC, CCN 420087
  • Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110
  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Hospital Inc Emergency Medicine CurrentSince Jan 1, 2008 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Emergency Medicine CurrentSince Oct 12, 2015 Accepting new patients
Broad River Physicians Group, LLC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Roper St. Francis Mount Pleasant Hospital Current Accepting new patients
Roper St. Francis Mount Pleasant Hospital Emergency Medicine CurrentSince Nov 11, 2010 Accepting new patients
Roper Hospital Inc. CurrentSince Jan 1, 2008 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Oct 12, 2015 Accepting new patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Nov 11, 2010 Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients
Cox Surgical LLC Past Accepting new patients
Bamberg County Memorial Hospital Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

730 Stony Landing Rd
Moncks Corner, SC 29461
Phone (843) 572-9211

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

7832 Rivers Ave
North Charleston, SC 29406
Phone (843) 824-8733

101 Sawmill Centre Dr
Summerville, SC 29483

100 Callen Blvd
Summerville, SC 29486
Phone (845) 529-3165

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Roper Hospital IncCharleston, SC, CCN 420087 Hospital Corporate Director Jul 1, 2018
Roper Hospital IncCharleston, SC, CCN 42T087 Hospital Corporate Director Jul 1, 2018
Roper St. Francis Home HealthCharleston, SC, CCN 427042 Home health agency Corporate Director Jul 1, 2018
Roper HospiceLadson, SC, CCN 421612 Hospice Corporate Director Jul 1, 2018

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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 3

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1790745701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601495",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601495",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CALHOUN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011113",
            "telephone_number": "843-724-2010",
            "fax_number": "843-724-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS",
        "first_name": "RUSSELL",
        "middle_name": "H G",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "25081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250819",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.