RUSSELL WALTERS (NPI# 1952724403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952724403 |
| Entity Type | Individual |
| Full Name | RUSSELL WALTERS |
| Credential | PA-C |
| Practice Address |
110 Hospital Dr Jefferson City TN 37760-5281 |
| Mailing Address |
1431 Centerpoint Blvd Suite 100 Knoxville TN 37932-1984 |
| Practice Telephone | 8654712300 |
| Practice Fax Number | 8654712463 |
| Mailing Telephone | 8659857012 |
| Mailing Fax Number | 8652913224 |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2014-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
110 HOSPITAL DR |
| City | JEFFERSON CITY |
| State | TN |
| Zip Code | 37760-5281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619302858 | Tabetha Ann Sparks | Nurse Practitioner | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2013-09-06 |
| 1912249814 | Joshua Porter | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2013-03-19 |
| 1205152105 | Richard Baird | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2010-04-16 |
| 1891022026 | Nancy Samsel Walker | Registered Nurse | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2009-11-09 |
| 1306036926 | Ashlea Brooke Daniel | Nurse Practitioner | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2007-07-30 |
| 1831247519 | Tennessee Cancer Specialists Pllc | Internal Medicine | 110 Hospital Dr, St Mary's Jefferson Memorial Hospital, Jefferson City, TN 37760-5281 | 2007-01-08 |
| 1760530927 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 110 Hospital Dr, Suite G50, Jefferson City, TN 37760-5281 | 2007-01-06 |
| 1700981271 | Nathan Roger Gilbert | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2006-09-13 |
| 1053354068 | John W. Burckle | Physician Assistant | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2006-06-14 |
| 1114960101 | Justin B. Mcgoldrick | Emergency Medicine | 110 Hospital Dr, Jefferson City, TN 37760-5281 | 2006-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699235929 | Emmley L Cole | Nurse Practitioner | 277 E W Broadway Blvd, Jefferson, TN 37760 | 2019-03-22 |
| 1275044877 | Cindy Anderson | Nurse Practitioner | 277 E Broadway Blvd, Jefferson City, TN 37760 | 2017-10-23 |
| 1801259940 | Mcfarland Group, Inc. | Durable Medical Equipment & Medical Supplies | 665 E Broadway Blvd, Jefferson City, TN 37760 | 2016-04-04 |
| 1124422266 | Penny Williams-cordeiro | Nurse Practitioner | 1901 Brookside Drive, Suite 105, Kingsport, TN 37760 | 2014-10-17 |
| 1215363841 | Lindsey Ann Clyde | Physician Assistant | 120 Hospital Dr Ste 130, Jefferson City, TN 37760 | 2013-09-14 |
| 1679849814 | Allison Renee Farris | Surgery | 120 Hospital Dr Ste G20, Jefferson City, TN 37760 | 2012-03-31 |
| 1245562891 | Steven Jarvis Monroe | Dentist | 156 W. Broadway Blvd., Jefferson City, TN 37760 | 2010-02-08 |
| 1952560625 | Summit Medical Group,pllc | Internal Medicine | 380 W Broadway Blvd, Jefferson City, TN 37760 | 2008-06-06 |
| 1780756189 | Steven J Monroe Dds PC | Dentist | 156 W Broadway Blvd, Jefferson City, TN 37760 | 2006-11-14 |
| 1720188600 | Dennis U Spjut | Psychologist | 732 E Jefferson St, Dennis Spjut Phd, Jefferson City, TN 37760 | 2006-09-22 |
| Find all providers in zip 37760 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760016141 | Julianna Christine Link | Physician Assistant | 1002 Diamond Rdg Ste 1200, Jefferson City, MO 65109-7911 | 2020-02-25 |
| 1215363841 | Lindsey Ann Clyde | Physician Assistant | 120 Hospital Dr Ste 130, Jefferson City, TN 37760 | 2013-09-14 |
| 1730646084 | Angela Brooke Burkhalter | Physician Assistant | 120 Hospital Dr, Jefferson City, TN 37760-5287 | 2019-02-22 |
| 1972076750 | Jennifer Esther Wekenborg | Physician Assistant | 1125 Madison St, Jefferson City, MO 65101-5200 | 2019-01-04 |
| 1871075754 | Zamara W Qureshi | Physician Assistant | 1511 Christy Dr, Jefferson City, MO 65101-2854 | 2018-09-06 |
| 1013374503 | Aaron C. Harris | Physician Assistant | 120 Hospital Dr, Suite 130, Jefferson City, TN 37760-5287 | 2016-01-28 |
| 1376948927 | Sarah E. Chapman | Physician Assistant | 120 Hospital Dr Ste 130, Jefferson City, TN 37760-5279 | 2014-10-24 |
| 1144578659 | Cole Physician Services LLC | Physician Assistant | 100 St. Mary's Medical Plaza, Jefferson City, MO 65101 | 2012-08-15 |
| 1053697565 | Joanna P. Smith | Physician Assistant | 2505 Mission Dr, Suite 200, Jefferson City, MO 65109-9508 | 2011-10-27 |
| 1780968701 | Misha Anne Holte | Physician Assistant | 2707 W Edgewood Dr, Suite 102, Jefferson City, MO 65109-5888 | 2011-10-10 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 37760 |
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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.