Mary C Russell, APRN in Blaine, TN - Medicare Nurse Practitioner

Mary C Russell, APRN is a medicare enrolled "Nurse Practitioner - Family" in Blaine, Tennessee. Her current practice location is 180 Emory Rd, Blaine, Tennessee. You can reach out to her office (for appointments etc.) via phone at (865) 933-4110.

Mary C Russell is licensed to practice in Tennessee (license number APN5921) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1447258652.

Contact Information

	Mary C Russell, APRN
	180 Emory Rd, Blaine, TN 37709-2420
	(865) 933-4110
	(865) 933-4729

Map and Direction

Provider's Profile

Full Name	Mary C Russell
Gender	Female
Speciality	Nurse Practitioner - Family
Location	180 Emory Rd, Blaine, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447258652
Provider Enumeration Date: 07/12/2005
Last Update Date: 09/11/2025

Medicare PECOS Information:

PECOS PAC ID: 4284791567
Enrollment ID: I20090401000334

Medical Identifiers

Medical identifiers for Mary C Russell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447258652	NPI	-	NPPES
3342488	Medicaid	TN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	RN65079 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	APN5921 (Tennessee)	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. Mary C Russell allows following entities to bill medicare on her behalf.

Entity Name	Faculty Internal Medicine Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417095308 PECOS PAC ID: 4789582305 Enrollment ID: O20031222000008

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. Mary C 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
Mary C Russell, APRN Department 888182, Knoxville, TN 37995-0001 Ph: (800) 355-3565	Mary C Russell, APRN 180 Emory Rd, Blaine, TN 37709-2420 Ph: (865) 933-4110

Reviews and Comments

Nurse Practitioner Nurses in Blaine, TN

Mrs. Chandra B. Blanken, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1066 Rutledge Pike, Blaine, TN 37709 Phone: 865-933-9477 Fax: 865-933-9466
Crystal L Larrimore, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 880 Rutledge Pike, Blaine, TN 37709 Phone: 865-933-4110 Fax: 865-933-4729
Wanda Fay White, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 586 Rutledge Pike, Blaine, TN 37709 Phone: 865-705-2624
Tammy Gould, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1066 Rutledge Pike, Blaine, TN 37709 Phone: 865-933-9477 Fax: 865-933-9466
Ms. Sharon Key Payne, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1066 Rutledge Pike, Blaine, TN 37709 Phone: 865-933-9477 Fax: 865-933-9466
Rebecca Gail Patton, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1117 Cliff Top Rd, Blaine, TN 37709 Phone: 865-719-6290

Mary C Russell, APRN - Medicare Nurse Practitioner in Blaine, TN