| Russell Medical | |
|
4355 Browns Bridge Rd Ste 1 Cumming GA 30041-4554 | |
| (770) 771-5050 | |
| (770) 771-5051 |
| Full Name | Russell Medical |
|---|---|
| Speciality | Family Medicine |
| Location | 4355 Browns Bridge Rd Ste 1, Cumming, Georgia |
| Authorized Official Name and Position | Brandee Nicole Urrutia (PRESIDENT / OWNER) |
| Authorized Official Contact | 7707715050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Medical 4355 Browns Bridge Rd Ste 1 Cumming GA 30041-4554 Ph: (770) 771-5050 | Russell Medical 4355 Browns Bridge Rd Ste 1 Cumming GA 30041-4554 Ph: (770) 771-5050 |
| NPI Number | 1649536749 |
|---|---|
| Provider Enumeration Date | 04/03/2012 |
| Last Update Date | 07/14/2022 |
| Medicare PECOS PAC ID | 5395909857 |
|---|---|
| Medicare Enrollment ID | O20120613000168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649536749 | NPI | - | NPPES |
| 202G709404 | Other | GA | PTAN MEDICARE |
| 11D2043142 | Other | GA | CLIA |
| Provider Name | Laura Kay Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952637605 PECOS PAC ID: 0244369783 Enrollment ID: I20100521000643 |
| Provider Name | Dustin L Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922260066 PECOS PAC ID: 7517136294 Enrollment ID: I20110815000523 |
| Provider Name | Brandee Nicole Urrutia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851552053 PECOS PAC ID: 3577730431 Enrollment ID: I20120117000417 |
| Provider Name | Esther Jackson Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811376098 PECOS PAC ID: 3971895988 Enrollment ID: I20160712002759 |
| Provider Name | Amanda N Cleghorne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104277474 PECOS PAC ID: 6901187707 Enrollment ID: I20170111000067 |
| Provider Name | Tonya Michelle Smith Moretz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700378197 PECOS PAC ID: 6002165644 Enrollment ID: I20180815002421 |
| Provider Name | James Cleveland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942895321 PECOS PAC ID: 3870997257 Enrollment ID: I20210806001427 |
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