Kelly Russin, PA is a medicare enrolled "Physician Assistant" in Union City, Georgia. She graduated from nursing school in 2003 and has 21 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Southside Medical Care and her current practice location is
6325 Shannon Pkwy, Suite D, Union City, Georgia. You can reach out to her office (for appointments etc.) via phone at
(770) 964-1400.
Kelly Russin is licensed to practice in Georgia (license number 004096) 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 1780745554.
Provider's Profile
| Full Name | Kelly Russin |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 21 Years |
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| Location | 6325 Shannon Pkwy, Union City, Georgia |
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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:
- Kelly Russin graduated from nursing school in 2003
NPI Data:
- NPI Number: 1780745554
- Provider Enumeration Date: 12/13/2006
- Last Update Date: 07/26/2012
Medicare PECOS Information:
- PECOS PAC ID: 0446426217
- Enrollment ID: I20111228000258
Medical Identifiers
Medical identifiers for Kelly Russin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780745554 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 004096 (Georgia) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southside Medical Care | 9931180650 | 2 |
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. Kelly Russin 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 |
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Kelly Russin, PA
6325 Shannon Pkwy, Suite D,
Union City, GA 30291-1538
Ph: (770) 964-1400 | Kelly Russin, PA
6325 Shannon Pkwy, Suite D,
Union City, GA 30291-1538
Ph: (770) 964-1400 |
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