Dr Shelley W Russell, MD is a medicare enrolled "Dermatology" physician in Conway, Arkansas. She went to University Of Arkansas College Of Medicine and graduated in 1999 and has 25 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Russell Dermatology Of Conway, Pllc and her current practice location is
2425 Dave Ward Dr, Suite 202, Conway, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(501) 328-5050.
Dr Shelley W Russell is licensed to practice in Arkansas (license number E1574) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1457330011.
Physician's Profile
| Full Name | Dr Shelley W Russell |
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| Gender | Female |
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| Speciality | Dermatology |
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| Experience | 25 Years |
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| Location | 2425 Dave Ward Dr, Conway, Arkansas |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Shelley W Russell attended and graduated from University Of Arkansas College Of Medicine in 1999
NPI Data:
- NPI Number: 1457330011
- Provider Enumeration Date: 01/12/2006
- Last Update Date: 11/09/2010
Medicare PECOS Information:
- PECOS PAC ID: 1850417791
- Enrollment ID: I20101029000021
Medical Identifiers
Medical identifiers for Dr Shelley W Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457330011 | NPI | - | NPPES |
| 140525001 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | E1574 (Arkansas) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Russell Dermatology Of Conway, Pllc | 2961528807 | 4 |
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. Dr Shelley W Russell allows following entities to bill medicare on her behalf.
| Entity Name | Russell Dermatology Of Conway, Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1639134067
PECOS PAC ID: 2961528807
Enrollment ID: O20100928001049 |
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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. Dr Shelley W 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 |
|---|
Dr Shelley W Russell, MD
2425 Dave Ward Dr, Suite 202,
Conway, AR 72034-8686
Ph: (501) 328-5050 | Dr Shelley W Russell, MD
2425 Dave Ward Dr, Suite 202,
Conway, AR 72034-8686
Ph: (501) 328-5050 |
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