NPIMap

Individual provider Active NPI

Charles Rayfield Russell III, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Jacksonville, FL
National Provider Identifier
1922539857
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
ME152163 Issued in FL
Practice address
3 Shircliff Way Ste 625
Jacksonville, FL 32204-4776
Phone
(904) 308-6900
Fax
(904) 308-6927
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X ME152163 FL
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME152163 FL
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X ME152163 FL Primary

Addresses

Primary practice location

3 Shircliff Way Ste 625
Jacksonville, FL 32204-4776

Mailing address

3 Shircliff Way Ste 625
Jacksonville, FL 32204-4776
Phone (904) 308-6900

Other practice location 1

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 639-2000

Other practice location 2

2201 S. Sterling Street
Carolinas HealthCare System Blue Ridge
Morganton, NC 28655
Phone (678) 481-2813

Other practice location 3

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 250-2506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210813000591 FL Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 0941530539 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

119 Oakfield Dr
Brandon, FL 33511-5779
Phone (561) 997-0821

1801 Barrs St
Suite 120
Jacksonville, FL 32204-4738
Phone (904) 308-2006

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Mar 30, 2026 Accepting new patients
Florida Hospital Medical Group Inc Multi-Specialty CurrentSince Sep 15, 2025 Accepting new patients
St Vincents Ambulatory Care Inc Multi-Specialty CurrentSince Mar 30, 2026 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 15, 2025 Accepting new patients

Locations

3 Shircliff Way
Ste 625
Jacksonville, FL 32204
Phone (904) 308-6900

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 7

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1922539857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SHIRCLIFF WAY STE 625",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044776",
            "telephone_number": "904-308-6900",
            "fax_number": "904-308-6927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHIRCLIFF WAY STE 625",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044776",
            "telephone_number": "904-308-6900",
            "fax_number": "904-308-6927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Kingsley Ave",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735148",
            "country_code": "US",
            "telephone_number": "904-639-2000",
            "fax_number": "904-639-2015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 S. Sterling Street",
            "address_2": "Carolinas HealthCare System Blue Ridge",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "28655",
            "country_code": "US",
            "telephone_number": "678-481-2813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Tampa General Cir",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-250-2506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHARLES",
        "middle_name": "RAYFIELD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME152163",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME152163",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME152163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.