RUSSELL B SMITH (NPI# 1134112261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134112261 |
| Entity Type | Individual |
| Full Name | RUSSELL B SMITH |
| Credential | MD |
| Practice Address |
1301 Palm Ave Jacksonville FL 32207-8432 |
| Mailing Address |
Po Box 45278 Jacksonville FL 32232-5278 |
| Practice Telephone | 9042027300 |
| Practice Fax Number | 9042027433 |
| Mailing Telephone | 9042022092 |
| Mailing Fax Number | 9043937603 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2019-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | ME134346 | FL | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 24197 | NE | Allopathic & Osteopathic Physicians |
| N | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
ME134346 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10025044400 | 05 | |
| IA | WELLMARK BCBS | 19770 | 01 |
| IA | 1134112261 | 05 | |
| NE | 47078557504 | 05 | |
| IA | 0212142 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639611767 | Russell Smith | Nurse Practitioner | 1230 Bay Dale Dr, Arnold, MD 21012-2325 | 2016-11-07 |
| 1184174229 | Russell Smith | Pharmacist | 2114 Chatalet Ln Apt L, Pueblo, CO 81005-4602 | 2016-10-13 |
| 1346594439 | Russell Alan Smith | Specialist/Technologist, Other | 1819 Jay Ell Dr # 1, Richardson, TX 75081-1837 | 2012-10-29 |
| 1912236241 | Russell Charles Smith | Dentist | 9131 Parkway East, Birmingham, AL 35206-1552 | 2009-12-16 |
| 1083840011 | Russell E Smith | Pharmacist | 533 N Main St, Troutman, NC 28166-8526 | 2009-06-04 |
| 1962666529 | Russell Smith | Dentist | 6415 Business Park Loop Rd Ste J, Park City, UT 84098-6218 | 2008-07-14 |
| 1255547386 | Russell John Smith | Dentist | 7209 265th St Nw, Suite 201, Stanwood, WA 98292-6292 | 2007-05-15 |
| 1467595025 | Russell Lynn Smith | Specialist | 8330 E Quincy Ave Apt D212, Denver, CO 80237-2456 | 2007-02-14 |
| 1841377553 | Russell Gene Smith | Physical Therapy Assistant | 100 Healthy Way # 1110, Anderson, SC 29621-2067 | 2006-11-01 |
| 1477637817 | Russell R. Smith | Internal Medicine | 1005 Union School Rd, Gallatin, TN 37066-2084 | 2006-10-24 |
| Street Address |
1301 PALM AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669096897 | Kimberly Nguyen Blythe | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2020-06-03 |
| 1609409945 | Emma Kate Alpert | Physician Assistant | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2020-02-14 |
| 1053964403 | Caitlyn Mitchell | Genetic Counselor, MS | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2019-07-24 |
| 1972167740 | Jessica C Terrell | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2019-04-27 |
| 1689135998 | Ghazal S Vafabakhsh | Physician Assistant | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2019-03-28 |
| 1710456215 | Jacquelene Marie Carson | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2018-11-14 |
| 1770059008 | Leslie Shannan Weaver | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2018-10-14 |
| 1659852325 | Patrick Alan Regis | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2018-08-22 |
| 1568941276 | Baptist-southeast Gynecologic Oncology Associates Inc | Internal Medicine | 1301 Palm Ave, Jacksonville, FL 32207 | 2018-08-13 |
| 1306323928 | Ashley Kohler | Physician Assistant | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2018-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437658671 | Baptist Ent Specialists Inc | Otolaryngology | 11236 Baptist Health Dr Ste 330, Jacksonville, FL 32218-2989 | 2018-02-02 |
| 1740562875 | Onslow Ambulatory Services, Inc. | Otolaryngology | 55 Office Park Dr, Jacksonville, NC 28546-7327 | 2011-09-14 |
| 1225317217 | Joseph Fares Md Pa | Otolaryngology | 4306 University Blvd S, Jacksonville, FL 32216-4910 | 2011-08-09 |
| 1720394695 | Rodolfo Enrique Manosalva | Otolaryngology | 554 Keily St., Jacksonville, FL 32212-5000 | 2010-08-29 |
| 1700060555 | Iman Naseri | Otolaryngology | 6817 Southpoint Parkway, Suite 502, Jacksonville, FL 32216-6289 | 2007-12-27 |
| 1366504342 | Dayananda Mulur Shetty | Otolaryngology | 9831 Del Webb Parkway, #2305, Jacksonville, FL 32256-5807 | 2006-12-15 |
| 1255406898 | Justin Randolph Moy | Otolaryngology | 14546 Old Saint Augustine Rd Ste 301, Jacksonville, FL 32258-5472 | 2006-11-21 |
| 1427122118 | Joseph Fares | Otolaryngology | 4306 University Blvd South, Jacksonville, FL 32216 | 2006-11-17 |
| 1952470874 | Lawrence Albert Lisska | Otolaryngology | 4130 Salisbury Rd, Suite 1900, Jacksonville, FL 32216-8031 | 2006-11-07 |
| 1558376004 | Advanced Otolaryngology Services Pa | Otolaryngology | 3627 University Blvd S Ste 210, Jacksonville, FL 32216-4256 | 2006-07-30 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.