ZACHARY RUSSELL (NPI# 1750753182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750753182 |
| Entity Type | Individual |
| Full Name | ZACHARY RUSSELL |
| Credential | ATC, LAT, CSCS, OTC |
| Practice Address |
1305 Jennings Mill Road Building 300, Suite 110 Watkinsville GA 30677 |
| Mailing Address |
5883 N Nevada Ave 324 Colorado Springs CO 80918-3507 |
| Practice Telephone | 7066135880 |
| Practice Fax Number | 7066135880 |
| Mailing Telephone | 6784816519 |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2019-09-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
AT003715 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 0001416 | CO | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2200 Bonforte Blvd, Pueblo, CO 810014901 | 6784816519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093346264 | Zachary Russell | Registered Nurse | 100 N Academy Ave, Danville, PA 17822-9800 | 2020-01-28 |
| 1619032836 | Zachary D Russell | Dentist | Usa Dental Health Activity, Bldg 38801 Academic Dr, Ste B&c, Ft Gordon, GA 30905-5660 | 2006-12-27 |
| Street Address |
1305 JENNINGS MILL ROAD BUILDING 300, SUITE 110 |
| City | WATKINSVILLE |
| State | GA |
| Zip Code | 30677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071478 | Brenda Gerai James | Behavior Technician | 1272 Virgil Langford Rd, Ste 101, Watkinsville, GA 30677 | 2020-10-22 |
| 1881292597 | Chloe Wise | Specialist/Technologist | 360 Caduceus Way Building 600 - Suite 101., Watkinsville, GA 30677 | 2020-10-14 |
| 1912518531 | Samuel S Kwon - Athens Dmd PC | Dentist | 1795 Resurgence Drive, Suite 101, Watkinsville, GA 30677 | 2020-08-17 |
| 1972131977 | Hopebridge LLC | Behavioral Analyst | 1272 Virgil Langford Road, Suite 101, Watkinsville, GA 30677 | 2020-03-27 |
| 1306479068 | Meggan Brittany Reed | Counselor | 1550 Jennings Mill Rd, Suite 1700b, Watkinsville, GA 30677 | 2020-02-20 |
| 1699322040 | Christopher's Bridge, LLC | In Home Supportive Care | 3651 Mars Hill Rd, Suite 1600, Watkinsville, GA 30677 | 2019-08-21 |
| 1093209538 | Haley Bauguss | Physician Assistant | 1624 Mars Hill Road, Suite B, Watkinsville, GA 30677 | 2018-06-19 |
| 1134618317 | Amanda Burns Denson | Nurse Practitioner | 1181 Langford Drive, Building 300, Suite 104, Watkinsville, GA 30677 | 2018-05-03 |
| 1780105528 | Inspiring Hospice Partners of Georgia LLC | Hospice Care, Community Based | 1252 Virgil Langford Rd, Watkinsville, GA 30677 | 2017-07-01 |
| 1255719720 | Elizabeth Hendrix | Social Worker | 1030 Barber Creek Drive, Suite 313, Watkinsville, GA 30677 | 2015-05-15 |
| Find all providers in zip 30677 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326679671 | Barbour Orthopaedics & Sports Medicine PC | Orthopaedic Surgery | 965 Oakland Rd Ste C, Lawrenceville, GA 30044-3758 | 2020-01-27 |
| 1932730298 | Barbour Orthopaedics & Sports Medicine PC | Orthopaedic Surgery | 1100 Northside Forsyth Dr Ste 360, Cumming, GA 30041-6022 | 2020-01-27 |
| 1275094310 | Mariolino Da Graca Fernandes | Orthopaedic Surgery | 3240 Northeast Expy Ne, Atlanta, GA 30341-4003 | 2019-03-29 |
| 1437601598 | Optim Orthopedics LLC | Orthopaedic Surgery | 460 Mall Blvd Ste B, Savannah, GA 31406-4801 | 2016-10-25 |
| 1396121315 | 2 Bare Bones Medical LLC | Orthopaedic Surgery | 11102 Abercorn St, Savannah, GA 31419-1822 | 2015-07-31 |
| 1578985180 | Brandon Dobo | Orthopaedic Surgery | 410 Brookhaven Way Ne, Atlanta, GA 30319-3177 | 2014-01-16 |
| 1306102785 | Elan J Golan | Orthopaedic Surgery | 1800 Tree Ln Ste 140, Snellville, GA 30078-6799 | 2012-04-10 |
| 1235405747 | Pinnacle Orthopaedics & Sports Medicine Specia | Orthopaedic Surgery | 1000 Chastain Road, Building II, Kennesaw, GA 30144-0000 | 2012-03-29 |
| 1346413648 | Mathew William Pombo | Orthopaedic Surgery | 3855 Pleasant Hill Rd Ste 470, Duluth, GA 30096-1417 | 2008-04-08 |
| 1053466615 | Georgia Sports Orthopedic Specialists | Orthopaedic Surgery | 1466 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3852 | 2007-01-24 |
| Find all providers with the same taxonomy | ||||
| City | WATKINSVILLE |
| Zip Code | 30677 |
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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.