PEGGY M RUSSELL (NPI# 1679598718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679598718 |
| Entity Type | Individual |
| Full Name | PEGGY M RUSSELL |
| Credential | D.O. |
| Practice Address |
1108 Lavaca St 110-320 Austin TX 78701-2172 |
| Practice Telephone | 5124774088 |
| Mailing Telephone | 5124774088 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2011-05-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
F4461 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 097796902 | 05 | |
| TX | MEDICARE RAILROAD | 110180474 | 01 |
| TX | BCBS TEXAS | 82020J | 01 |
| Street Address |
1108 LAVACA ST 110-320 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78701-2172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134754997 | Shan Qiu | Nurse Practitioner | 1108 Lavaca St, Austin, TX 78701-2172 | 2020-03-11 |
| 1083155832 | Louisa Giuliana Werner Crosby | Nurse Practitioner | 1108 Lavaca St, Suite 110-320, Austin, TX 78701-2172 | 2017-03-13 |
| 1417211970 | Jordan Sondgeroth | Clinical Nurse Specialist | 1108 Lavaca St, Suite 110-320, Austin, TX 78701-2172 | 2012-06-29 |
| 1023392461 | Michelle Coffey | Clinical Nurse Specialist | 1108 Lavaca St, Suite 110-320, Austin, TX 78701-2172 | 2011-10-04 |
| 1740588623 | Wendy Wing | Clinical Nurse Specialist | 1108 Lavaca St, Suite 110-320, Austin, TX 78701-2172 | 2011-03-02 |
| 1366771321 | Melinda Gunadi Daniel | Clinical Nurse Specialist | 1108 Lavaca St, Suite 110-320, Austin, TX 78701-2172 | 2009-12-21 |
| 1144481003 | Haiyan Liu | Clinical Nurse Specialist | 1108 Lavaca St, Suite 110-320, Austin, TX 78701-2172 | 2008-06-23 |
| 1740461375 | Ping Ye | Clinical Nurse Specialist | 1108 Lavaca St, Suite 110-320, Austin, TX 78701-2172 | 2007-11-26 |
| 1144364464 | Meena V. Rhodes | Internal Medicine | 1108 Lavaca St, Suite 110-320, Austin, TX 78701-2172 | 2007-02-19 |
| 1164446035 | Mary Neusch Mann | Nurse Practitioner | 1108 Lavaca St, Suite 110-320, Austin, TX 78701-2172 | 2006-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710501820 | Megan Elise Gittins | Student in an Organized Health Care Education/Training Program | Ut Austin Dell Medical School 1400 Ih-35, Cec 300, Austin, TX 78701 | 2020-06-04 |
| 1306467956 | Jason Russell Paxman | Internal Medicine | Dell Seton Medical Center 1500 Red River, Austin, TX 78701 | 2020-05-05 |
| 1992326078 | Sarah N Ibanez Shaw | Emergency Medicine | Ut Austin Dell Medical School Em Residency Program, 1400 N. I-35, Suite 2.230, Austin, TX 78701 | 2020-04-30 |
| 1215558689 | Margaret Marie Coates | Student in an Organized Health Care Education/Training Program | 1400 N Interstate Highway 35, Cec 2.404, Austin, TX 78701 | 2020-04-27 |
| 1740817956 | Woody Starcloud Green | Emergency Medicine | Dell Emergency Medicine Residency Program, 1400 N. Interstate Hwy 35, Suite 2.230, Austin, TX 78701 | 2020-03-26 |
| 1235771403 | Central Ortho Assists Pllc | Physician Assistant | 501 Congress, Suite 150, Austin, TX 78701 | 2019-10-09 |
| 1114575792 | Shyneice Lasha Gaddis | Behavior Technician | 100 Congress Ave Suite 2000, Austin, TX 78701 | 2019-08-28 |
| 1245887355 | Jonathan Thomas Mason | Family Medicine | 1400 N-ih 35, Dell Seton Medical Center, Ste C2.410, Austin, TX 78701 | 2019-08-22 |
| 1538726195 | Zahra Virginia Cain-akbar | Student in an Organized Health Care Education/Training Program | Ut Dell Medical, 1500 Red River St, Austin, TX 78701 | 2019-05-20 |
| 1457918021 | Sara Lugonjic | Student in an Organized Health Care Education/Training Program | Ut Austin Dell Medical School Neurology Program, 1400 Ih- 35, Cec 300, Austin, TX 78701 | 2019-05-20 |
| Find all providers in zip 78701 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841634854 | Michael L. Krol | Internal Medicine | 1108 Lavaca St Ste 110-320, Austin, TX 78701-2172 | 2013-04-20 |
| 1558530048 | Denise Rene Moraw | Internal Medicine | 9007 Rock Way Dr, Austin, TX 78736-7731 | 2008-02-28 |
| 1548319916 | Leslie Ludwig Cortes | Internal Medicine | 12401 Research Blvd Ste 220, Austin, TX 78759-2314 | 2007-01-09 |
| 1669469235 | Mary S Maxwell | Internal Medicine | 4107 Medical Pkwy Ste 210, Austin, TX 78756-3738 | 2005-09-29 |
| 1780681163 | George Randolph Robison | Internal Medicine | 1000 Payton Gin Rd, Ste S, Austin, TX 78758-6766 | 2005-06-30 |
| 1558789487 | Joan E Lange | Internal Medicine | 1108 Lavaca St Ste 110-320, Austin, TX 78701-2172 | 2014-03-28 |
| 1063774602 | Steven K. Booton, M.d., P.a. | Internal Medicine | 720 W 34th St, Suite 100, Austin, TX 78705-1205 | 2012-06-11 |
| 1013247980 | Harden Clinical Services LLC | Internal Medicine | 3307 Northland Dr, Austin, TX 78731-4946 | 2009-12-28 |
| 1801055587 | Sarah Elizabeth Matt | Internal Medicine | 6448 E Hwy 290, Suite # D-103, Austin, TX 78723-1068 | 2008-06-06 |
| 1396887691 | Archie Dan Smith Jr. | Internal Medicine | 1215 Red River, Austin, TX 78701-1921 | 2007-02-13 |
| Find all providers in AUSTIN | ||||
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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.