Chelsea Lynn Russell

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117653 Issued in FL

Practice address

362 Beal Pkwy N Ste 105
Fort Walton Beach, FL 32548-3926

Phone

(850) 862-3020

Fax

(850) 862-1363

NPI assigned

Jun 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Chelsea Lynn Callahan Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All Seasons Allergy and Asthma Center, P.a.Group PAC ID 2264465376, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• All Seasons Allergy and Asthma Center, P.a.

  • Allergy & Immunology Physician
  • Fort Walton Beach, FL
  • NPI 1578618104
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1962997650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 BEAL PKWY N STE 105",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325483926",
            "telephone_number": "850-862-3020",
            "fax_number": "850-862-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 BEAL PKWY N STE 105",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325483926",
            "telephone_number": "850-862-3020",
            "fax_number": "850-862-1363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 Madison Oak Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782583920",
            "country_code": "US",
            "telephone_number": "210-499-4824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2050 36th Ave SW Ste 201",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587017595",
            "country_code": "US",
            "telephone_number": "701-852-8502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHELSEA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": "PA11842",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0860",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "CALLAHAN",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brenda Royster
• Ashton Starr Ruffin, PHARMD
• Anastasia Ruiz, MD
• Ruben Jonathan Ruiz, DPT
• Sara A Rushing, MD
• David Lee Russell Sr., DMD, MS.
• Maggie Russell, CCC-SLP
• Juliette Adelle Russo, PA-C
• Walter Clifford Rustmann, DO
• S a Levitus L C S W P a

• Physician Assistant in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.