DR. CHARLES RAYFIELD RUSSELL III (NPI# 1922539857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922539857 |
Entity Type | Individual |
Full Name | DR. CHARLES RAYFIELD RUSSELL III |
Credential | M.D. |
Practice Address |
2001 Kingsley Ave Orange Park FL 32073-5148 |
Mailing Address |
6371 Collins Rd Apt 803 Jacksonville FL 32244-7524 |
Practice Telephone | 9046392000 |
Practice Fax Number | 9046392015 |
Mailing Telephone | 6784812813 |
Enumeration Date | 2017-03-22 |
Last Update Date | 2019-03-26 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | 081380 | GA | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
2201 S. Sterling Street, Carolinas Healthcare System Blue Ridge, Morganton, NC 28655 | 6784812813 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700486750 | Charles Mcpherrin Russell | Pharmacist | 6301 Nw Quannah Parker Trl, Lawton, OK 73505-1326 | 2020-10-29 |
1306336847 | Charles R Russell | Behavior Technician | 4520 S Huron St, Englewood, CO 80110-5636 | 2018-05-10 |
1245220912 | Charles E Russell | 579 Rustic Trl, Beavercreek, OH 45434-7337 | 2005-10-25 | |
1548264328 | Charles Mark Russell | Dentist | 163 Beech St, Harrogate, TN 37752-8208 | 2005-06-09 |
1457833626 | Charles William Russell | Psychologist | 8901 New Hampshire Ave, Silver Spring, MD 20903-3611 | 2018-09-04 |
1043569940 | Charles R Russell | Chiropractor | 3555 Clares St, Suite Ww, Capitola, CA 95010-2555 | 2012-09-06 |
1568724003 | Charles Joseph Russell | Counselor | 315 N Lakemont Ave, Winter Park, FL 32792-3205 | 2012-06-11 |
1841404159 | Charles Edward Russell | Counselor | 1644 S College Ave, Fort Collins, CO 80525-1007 | 2007-05-09 |
1366575185 | Charles Russell | Case Manager/Care Coordinator | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2007-03-13 |
1386669356 | Charles A Russell | Specialist | 2820 Griffin Ave Ste 210, Enumclaw, WA 98022-2373 | 2006-07-12 |
Street Address |
2001 KINGSLEY AVE |
City | ORANGE PARK |
State | FL |
Zip Code | 32073-5148 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417959172 | John Dunlap | Nurse Anesthetist, Certified Registered | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2005-08-12 |
1528681657 | Michael Steadman Gerber | Registered Nurse | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-05-22 |
1831710961 | Marcus Ramzi Ibrahim | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
1497374839 | Ahmed Ebrahim | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-15 |
1386263267 | Martin Alla | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5156 | 2020-04-10 |
1275152399 | Elizabeth Joyce Bogaty | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-09 |
1104445113 | Amanda Brenner | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-09 |
1457980641 | Bordin Intachai | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-08 |
1942839444 | Michelle Lola | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5156 | 2020-04-06 |
1245869890 | Ashraf Abdulhalim | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
Find all providers in zip 32073 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043579816 | Teddy Garcia Md Pa | General Practice | 784 Blanding Blvd, Ste 108, Orange Park, FL 32065-8717 | 2012-05-14 |
1801073713 | Cristina Luciano M D P A | General Practice | 1555 Kingsley Ave, Suite #404, Orange Park, FL 32073-9207 | 2008-01-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265033823 | Bless Medical Center of Nmb LLC | General Practice | 1400 Ne Miami Gardens Dr Ste 209, North Miami Beach, FL 33179-4844 | 2020-11-02 |
1982203634 | Central Florida Wellness LLC | General Practice | 15516 W Colonial Dr Ste 111, Winter Garden, FL 34787-9558 | 2020-10-23 |
1760080212 | Summit Health Multi Specialty of Florida LLC | General Practice | 1881 W Kennedy Blvd Ste D, Tampa, FL 33606-1611 | 2020-10-15 |
1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
1992302574 | Avita Medical Clinic, LLC | General Practice | 14831 N Florida Ave, Tampa, FL 33613-1825 | 2020-10-06 |
1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
Find all providers with the same taxonomy |
City | ORANGE PARK |
Zip Code | 32073 |
Please comment or provide details below to improve the information on DR. CHARLES RAYFIELD RUSSELL III.
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.