NPIMap

Individual provider Active NPI

Brady Russell

  • Internal Medicine Physician
  • Tupelo, MS
National Provider Identifier
1942266341
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18566 Issued in MS
Practice address
845 S Madison St
Tupelo, MS 38801-4905
Phone
(662) 377-5930
Fax
(662) 377-5085
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18566 MS Primary

Addresses

Primary practice location

845 S Madison St
Tupelo, MS 38801-4905

Mailing address

845 S Madison St
Tupelo, MS 38801-4905
Phone (662) 377-5930

Other identifiers 1

IdentifierTypeStateIssuer
02439201MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20041018000451 MS Practitioner - HospitalistPractitioner - Internal Medicine 5698735215 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Arkansas College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

830 S Gloster
North Ms Med Ctr Sleep Lab
Tupelo, MS 38801-4934
Phone (662) 377-3258

830 S Gloster St
Tupelo, MS 38801-4934

830 S Gloster St 3Rd FL E Tower
Tupelo, MS 38801-4934

845 S Madison St
Tupelo, MS 38801-4905
Phone (662) 377-1100

860 S Madison St
Tupelo, MS 38801-4905
Phone (662) 377-7150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18566MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pontotoc Health Services, Inc. CurrentSince Dec 15, 2016 Accepting new patients
North Mississippi Medical Center, Inc. CurrentSince Oct 1, 2015 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center Services LLC Internal Medicine Current Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Oct 1, 2015 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
North Mississippi Medical Center Services LLC CurrentSince Oct 1, 2011 Accepting new patients
Pontotoc Health Services, Inc. Current Accepting new patients
North Mississippi Medical Center Services LLC CurrentSince Oct 1, 2011 Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients
Cogent Healthcare of Mississippi, Inc Internal Medicine Past Accepting new patients

Locations

176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

Interoperability endpoints

  • Direct secure messaging: bradyrussell@nmhs.medalliesdirect.net

Organizations & group practices 11

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 2

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1942266341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-377-5930",
            "fax_number": "662-377-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-377-5930",
            "fax_number": "662-377-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BRADY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "18566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02439201",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.