RUSSELL LEE SHORT (NPI# 1336355239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336355239 |
| Entity Type | Individual |
| Full Name | RUSSELL LEE SHORT |
| Credential | IDC |
| Practice Address |
7513 Brittany Lakes Dr Wilmington NC 28411 |
| Practice Telephone | 9105415341 |
| Mailing Telephone | 9105415341 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
7513 BRITTANY LAKES DR |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447744941 | Mercedes Wilkins Mclaughlin | Social Worker | 7008 Cape Harbor Dr Apt A, Wilmington, NC 28411 | 2018-06-18 |
| 1619480811 | Physical Therapy Services of Wilmington At Porter's Neck, LLC | Physical Therapist | 167 Porters Neck Road, Suite D, Suite D, Wilmington, NC 28411 | 2017-11-09 |
| 1578954970 | Erin Fitzpatrick Vasquez | Physical Therapist | 441 Biscayne Dr., Wilmington, NC 28411 | 2015-02-07 |
| 1679961932 | Sheena Cannady | Occupational Therapy Assistant | 7205 Savanna Run Loop, Wilmington, NC 28411 | 2015-01-08 |
| 1548510753 | Lindsey Tarrant Pediatric Speech Pathology Services | Speech-Language Pathologist | 7842 Olde Pond Rd, Wilmington, NC 28411 | 2012-09-14 |
| 1912224601 | Michele Ann Hardee | Physical Therapy Assistant | 1011 Porters Neck Road, Wilmington, NC 28411 | 2010-04-21 |
| 1629216577 | Plantation Village | In Home Supportive Care | 1200 Porters Neck Rd, Wilmington, NC 28411 | 2009-01-30 |
| 1467606095 | Dana B. Shumate Dds, Pa | Dentist | 8131 Market St, Wilmington, NC 28411 | 2008-11-10 |
| 1427212745 | Malgorzata Maria Betkowski | Counselor | 8044 Market Street, Suite D, Wilmington, NC 28411 | 2008-07-16 |
| 1366625014 | The Lawson's House | Day Training, Developmentally Disabled Services | 6622 F Gordan Rd, Wilmington, NC 28411 | 2007-12-17 |
| Find all providers in zip 28411 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518240423 | Michael Thomas Denoyer | Military Health Care Provider | 7302 Farrington Farms Dr, Wilmington, NC 28411-6199 | 2011-09-27 |
| 1457673022 | Michael Cameron Lewis | Military Health Care Provider | 7528 Foxwerth Dr, Wilmington, NC 28411-7352 | 2010-02-23 |
| 1336471374 | William Lee Fairall | Military Health Care Provider | 8161 Red Cockaded Ct Apt 103, Wilmington, NC 28411-7186 | 2010-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820002 | Levi Para | Military Health Care Provider | 2d Reconnaissance Bn, Psc 20138, Camp Lejeune, NC 28452-0138 | 2020-10-29 |
| 1427661743 | Russ C Garlinghouse | Military Health Care Provider | Rr 616, Stone Bay, NC 28460 | 2020-08-26 |
| 1164033197 | Brian David Bjerke | Military Health Care Provider | 612 Everrett Creek Road, Snead's Ferry, NC 28460 | 2020-08-13 |
| 1588274641 | Adam Randolph Smith | Military Health Care Provider | 205 Wintergreen Ln, Hubert, NC 28539-4659 | 2020-08-04 |
| 1588273999 | Jacob Johnson | Military Health Care Provider | 413 Salvo Ct, Holly Ridge, NC 28445-8609 | 2020-07-31 |
| 1790309565 | Jason C Smith | Military Health Care Provider | 113 Barrington Ct, Maple Hill, NC 28454-8659 | 2020-06-08 |
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1003444928 | Andres Martin Rodoni | Military Health Care Provider | 2nd Reconnaissance Battalion, Camp Lejune, NC 28542 | 2020-03-27 |
| 1699306670 | Dominick Ciampo | Military Health Care Provider | A66 Boat Basin Road, Camp Lejeune, NC 28542 | 2020-01-29 |
| 1487294682 | Daniel Scott Porterfield | Military Health Care Provider | Building Rr612, Loop Rd, Sneads Ferry, NC 28460 | 2020-01-15 |
| Find all providers with the same taxonomy | ||||
| City | WILMINGTON |
| Zip Code | 28411 |
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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.