Nicole Elizabeth Russell, MD
Individual provider Active NPI Family Medicine Physician · Sandpoint, ID
NPI 1982017968 · NPPES record last updated May 18, 2026
Key facts
- NPI
- 1982017968
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M-16119 (ID)
- Practice address
- 810 North 6TH Ave.
Sandpoint, ID 83864 - Phone
- (208) 265-6252
- NPI assigned
- Jun 6, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Boundary Regional Community Health Center Inc
Practice addresses (Care Compare)
6509 Hwy 2
Priest River, ID 83856-6633
Phone (208) 448-2321
6615 Comanche St
Bonners Ferry, ID 83805-7523
Phone (208) 267-1718
810 6TH Ave
Sandpoint, ID 83864-5396
Phone (208) 263-7101
PO Box
Sandpoint, ID 83864
Hospital & facility affiliations
- Bonner General Hospital
- Boundary Community Hospital
- Kootenai Health
- Newport Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in ID, FL, PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220307002347 | ID | Practitioner - Family Practice | 1759601230 | Reassigns benefits to 1 organization |
| I20260516000312 | FL | Practitioner - Nurse Practitioner | 1759601230 | Reassigns benefits to 1 organization |
| I20260526003970 | PA | Practitioner - Family Practice | 1759601230 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME179868 | FL | MD | Family Medicine Physician |
| M-16119 | ID | MD | Family Medicine Physician |
| MD494187 | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boundary Regional Community Health Center Inc | Current |
Accepting new patients | |
| Boundary Regional Community Health Center, Inc. | Family Medicine | Current |
Accepting new patients |
| Boundary Regional Community Health Center Inc | Family Medicine | Past | Accepting new patients |
| Boundary Regional Community Health Center, Inc. | Past | Accepting new patients |
Locations
6615 Comanche St
Bonners Ferry, ID 83805
Phone (208) 267-1718
6509 Highway 2
Ste 101
Priest River, ID 83856
Phone (208) 448-2321
810 N Sixth Ave
Sandpoint, ID 83864
Phone (208) 263-7101
Interoperability endpoints
- nicole.russell.1@32745.direct.athenahealth.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- nicole.russell.p1@direct.kch.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD494187 | PA | |
| Family Medicine Physician | 207Q00000X | MED-PHYS-LIC-58693 | MT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | M-16119 | ID | Yes |
| Family Medicine Physician | 207Q00000X | ME179868 | FL |
Addresses
Primary practice location
810 North 6TH Ave.
Sandpoint, ID 83864
Mailing address
810 North 6TH Ave.
Sandpoint, ID 83864
Phone (208) 265-6252
Other practice location 1
2418 E York St
Philadelphia, PA 19125-3006
Phone (888) 803-3370
Other practice location 2
2820 NE 214th St Ste 801
Aventura, FL 33180-1269
Phone (888) 803-3370
Other practice location 3
400 N Tampa St Fl 15
Tampa, FL 33602-4730
Phone (888) 803-3370
Other practice location 4
401 Railroad St W
Missoula, MT 59802-4109
Phone (406) 258-4789
Other practice location 5
1035 1st Ave W
Kalispell, MT 59901-5607
Phone (406) 751-8113
Other names
- Nicole Elizabeth Bierie
Other providers in Sandpoint, ID
- Dante Sandro Rumore
- Paul Gerald Rumore
- Rurban PLLC
- Rhonda Russ
- Amanda Louise Russell
- Paige Tara Russell
- Christina Marie Rust
- Robert Edward Rust Jr.
- Kimberly Amelia Rutland
- Safeway Inc
All providers in Sandpoint, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.