RUSSELL LEE MARTIN (NPI# 1730387051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730387051 |
| Entity Type | Individual |
| Full Name | RUSSELL LEE MARTIN |
| Credential | PA-C |
| Practice Address |
200 Veterans Ave Beckley WV 25801-6444 |
| Mailing Address |
775 Mount View Rd Cool Ridge WV 25825-9511 |
| Practice Telephone | 3042552121 |
| Mailing Telephone | 3042280626 |
| Enumeration Date | 2007-07-09 |
| Last Update Date | 2007-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588055313 | Russell Anthony Martin | Social Worker | 242 Bradhurst Ave Apt 22, New York, NY 10039-1421 | 2015-02-16 |
| 1942460340 | Russell Lionel Martin | Internal Medicine | 2225 E Randol Mill Rd, Suite 101, Arlington, TX 76011-6315 | 2008-06-10 |
| 1770741217 | Russell Richard Martin | Surgery | 1125 E Spruce Ave, Suite 101, Fresno, CA 93720-3385 | 2008-05-31 |
| Street Address |
200 VETERANS AVE |
| City | BECKLEY |
| State | WV |
| Zip Code | 25801-6444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396735981 | John David Berryman | Obstetrics & Gynecology | 200 Veterans Ave, Beckley, WV 25801-6444 | 2005-10-25 |
| 1265031991 | Kristy Lea Moeller | Nurse Practitioner | 200 Veterans Ave, Beckley, WV 25801-6444 | 2020-10-23 |
| 1316546047 | Candice Marie Young | Registered Nurse | 200 Veterans Ave, Beckley, WV 25801-6444 | 2020-10-23 |
| 1902403686 | Ashley Brooke Dorsey | Pharmacist | 200 Veterans Ave, Beckley, WV 25801-6444 | 2020-10-05 |
| 1487251450 | Victoria Ann Redden | Registered Nurse | 200 Veterans Ave, Beckley, WV 25801-6444 | 2020-10-02 |
| 1598371726 | Robert David Estepp II | Recreation Therapist | 200 Veterans Ave, Beckley, WV 25801-6444 | 2020-09-22 |
| 1316562978 | Leila Ann Tilley | Pharmacist | 200 Veterans Ave, Beckley, WV 25801-6444 | 2020-06-10 |
| 1811510001 | Hannah Davidson Keeney | Pharmacist | 200 Veterans Ave, Beckley, WV 25801-6444 | 2020-05-21 |
| 1841820628 | Staci Morgan Little | Social Worker | 200 Veterans Ave, Beckley, WV 25801-6444 | 2020-01-22 |
| 1104473354 | Liem Nguyen | Pharmacist | 200 Veterans Ave, Beckley, WV 25801-6444 | 2019-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144835190 | Misty Dawn Chambers | Psychologist | 154 Lagoon Way, Beckley, USA 25801 | 2020-09-15 |
| 1912511437 | Katherine Lynne Mcghee | Technician | 120 Schlager Dr., Beckley, WV 25801 | 2020-09-02 |
| 1255942421 | Tyesha Burger | Technician | 442 Industrial Dr, Beckley, WV 25801 | 2020-08-12 |
| 1053920553 | Angela Sanches | Case Manager/Care Coordinator | 134 Gooseberry Ln, Beckley, WV 25801 | 2020-07-30 |
| 1871119933 | Tiffani Michelle Dale | Counselor | 111 Coral Court, Apt 5, Beckley, WV 25801 | 2020-06-24 |
| 1679046049 | Liberty Dental Centers | Dentist | 102 Galleria Plaza, Beckley, WV 25801 | 2019-01-08 |
| 1952884942 | Susan Rae Rash | Nurse Practitioner | 250 Stanaford Rd Ste 203, Beckley, WV 25801 | 2018-09-14 |
| 1689169039 | Megan Rae Walker | Dentist | 3153 Robert C. Byrd Drive, Beckley, WV 25801 | 2018-06-28 |
| 1104318625 | Mountain State Vascular, Inc. | Surgery | 121 George Street, Beckley, WV 25801 | 2018-05-31 |
| 1356841100 | Harper Road Treatment Center LLC | Family Medicine | 1802 Harper Rd Ste 202, Beckley, WV 25801 | 2018-02-19 |
| Find all providers in zip 25801 | ||||
| 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 |
|---|---|---|---|---|
| 1871929554 | Christopher Todd Hatcher | Physician Assistant | 1836 Harper Rd., Beckley, WV 25801 | 2013-09-25 |
| 1497180285 | Felecia Morgan Smith | Physician Assistant | 321 S Eisenhower Dr, Beckley, WV 25801-5849 | 2013-09-11 |
| 1154760551 | Ronald Chad Miller | Physician Assistant | 138 Manor Dr, Beckley, WV 25801-2527 | 2013-06-19 |
| 1124354063 | Allie Reed | Physician Assistant | 250 Stanaford Rd., Suite 202, Beckley, WV 25801 | 2009-10-28 |
| 1144457839 | Shawn Alexander Toney | Physician Assistant | 1902 Harper Rd, Suite C, Beckley, WV 25801-2642 | 2009-06-19 |
| 1538337076 | S E Emergency Physicians | Physician Assistant | 124 Brookshire Lane, Beckley, WV 25801-6761 | 2008-02-19 |
| 1366582660 | Bryan D Caskey | Physician Assistant | 94 Brookshire Ln, Beckley, WV 25801-6765 | 2007-02-07 |
| 1013912328 | Michael D Mcmillion | Physician Assistant | 25 Mallard Ct, Beckley, WV 25801-3664 | 2005-06-15 |
| 1669476057 | Stephanie L Hamilton | Physician Assistant | 102 Brookshire Ln, Beckley, WV 25801-6761 | 2005-06-13 |
| 1144730664 | Gavriela Golden | Physician Assistant | 1710 Harper Rd, Beckley, WV 25801 | 2017-10-10 |
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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.