Travis Andre Russell, DDS in Society Hill, SC

Travis Andre Russell, DDS is a medicare enrolled "Dentist - Dental Public Health" provider in Society Hill, South Carolina. His current practice location is 737 S Main St, Society Hill, South Carolina. You can reach out to his office (for appointments etc.) via phone at (843) 857-0111.

Travis Andre Russell is licensed to practice in South Carolina (license number 9255) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1861976839.

Contact Information

	Travis Andre Russell, DDS
	737 S Main St, Society Hill, SC 29593-8972
	(843) 857-0111
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Travis Andre Russell
Gender	Male
Speciality	Dentist - Dental Public Health
Location	737 S Main St, Society Hill, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1861976839
Provider Enumeration Date: 09/17/2018
Last Update Date: 06/11/2019

Medicare PECOS Information:

PECOS PAC ID: 9830443597
Enrollment ID: I20181115000922

Medical Identifiers

Medical identifiers for Travis Andre Russell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861976839	NPI	-	NPPES
ZX9255	Medicaid	SC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223D0001X	Dentist - Dental Public Health	9255 (South Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Travis Andre Russell allows following entities to bill medicare on his behalf.

Entity Name	Caresouth Carolina Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720082571 PECOS PAC ID: 1052221314 Enrollment ID: O20040511000280

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Travis Andre Russell is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Travis Andre Russell, DDS Po Box 1090, Hartsville, SC 29551-1090 Ph: (843) 857-0111	Travis Andre Russell, DDS 737 S Main St, Society Hill, SC 29593-8972 Ph: (843) 857-0111

Reviews and Comments

Dentist in Society Hill, SC

Mae E Jesneck, DDS, LCSW Dentist Medicare: Not Enrolled in Medicare Practice Location: 737 S Main St, Society Hill, SC 29593 Phone: 843-378-3000 Fax: 843-378-9869
Dr. Sean G Boynes, DMD, MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 737 S Main St, Society Hill, SC 29593 Phone: 843-378-3000 Fax: 843-378-4209
Dr. Benjamin Craig Jordan, D.M.D. Dentist Medicare: Medicare Enrolled Practice Location: 737 S Main St, Society Hill, SC 29593 Phone: 866-815-9845 Fax: 800-882-4690
Dr. Heather K Kilpatrick, DMD Dentist Medicare: Medicare Enrolled Practice Location: 737 S Main St, Society Hill, SC 29593 Phone: 866-815-9845 Fax: 800-882-4690

Travis Andre Russell, DDS - Medicare Dentist in Society Hill, SC