Gregory A. Russell, MD
Individual provider Active NPI Family Medicine Physician · Midland, NC
NPI 1992770515 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1992770515
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2010-01130 (NC)
- Practice address
- 12925 Highway 601
Ste 300
Midland, NC 28107-9535 - Phone
- (704) 888-3702
- NPI assigned
- Feb 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of South Florida College of Medicine, 2002
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Carolinas Physicians Network Inc
Comprehab, Inc
Practice addresses (Care Compare)
12925 Hwy 601
Suite 300
Midland, NC 28107-9536
Phone (704) 888-3702
14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373
2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800
704 Gold Hill Rd
Suite 1200
Fort Mill, SC 29715-8906
Phone (704) 667-3380
Hospital & facility affiliations
- Atrium Healt at Home Stanly
- Atrium Health at Home Union
- Carolinas Medical Center/Behav Health
- Carolinas Medical Center-Northeast
- Stanly Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC, SC
- 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 |
|---|---|---|---|---|
| I20101004001106 | NC | Practitioner - Family Practice | 4789618802 | Reassigns benefits to 2 organizations |
| I20210608003120 | SC | Practitioner - Family Practice | 4789618802 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 226188 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Charlotte-Mecklenburg Hospital Authority | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Carolinas Physician Network, Inc. | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Family Medicine | Current |
Accepting new patients |
| The Charlotte-Mecklenburg Hospital Authority | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| The Charlotte-Mecklenburg Hospital Authority | Current | Accepting new patients | |
| The Charlotte-Mecklenburg Hospital Authority | Past | Accepting new patients | |
| Carolinas Physicians Network, Inc | Family Medicine | Past | Accepting new patients |
Locations
100 N 6th St
Ste 900A
Minneapolis, MN 55403
105 Yadkin St
Ste 101
Albemarle, NC 28001
Phone (704) 474-3171
10620 Park Rd
Ste 202
Charlotte, NC 28210
Phone (704) 512-3988
14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070
14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650
200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740
1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650
12925 Highway 601
Ste 300
Midland, NC 28107
Phone (704) 258-2444
269 S Main St
Norwood, NC 28128
Phone (704) 474-3171
704 Gold Hill Rd
Ste 1200
Fort Mill, SC 29715
Phone (704) 667-3380
Interoperability endpoints
- grussell136811@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2010-01130 | NC | Yes |
Addresses
Primary practice location
12925 Highway 601
Ste 300
Midland, NC 28107-9535
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
10620 Park Rd
Ste 202
Charlotte, NC 28210-8472
Phone (704) 667-0920
Other practice location 2
704 Gold Hill Rd
Ste 1200
Fort Mill, SC 29715-8906
Phone (704) 667-3380
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
| Direct Messaging Address | grussell136811@CarolinasHealthcareSystem.direct-ci.com | Atrium Health |
Other providers in Midland, NC
- Oak Path Counseling Group, PLLC
- Maria Helene Oxford
- Neha Patil
- Carmella Morrow Pryor
- Rha Howell Care Center
- Tricia Spinner
- The Charlotte-Mecklenburg Hospital Authority
- The Mental Health Association in North Carolina, Inc.
- Tammy Truett-Porter
- Ailene Vayas-Llera
All providers in Midland, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2024. 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.