Russell Edward Proffitt, CRNA, RN, BSN in Kingsport, TN - Medicare Certified Registered Nurse Anesthetist (crna)

Russell Edward Proffitt, CRNA, RN, BSN is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Kingsport, Tennessee. He graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Southeastern Surgical, Llc and his current practice location is 2601 N John B Dennis Hwy, Apt. 1001, Kingsport, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 315-9306.

Russell Edward Proffitt is licensed to practice in Tennessee (license number 18164) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1124440128.

Contact Information

	Russell Edward Proffitt, CRNA, RN, BSN
	2601 N John B Dennis Hwy, Apt. 1001, Kingsport, TN 37660-0812
	(423) 315-9306
	Not Available

Map and Direction

Provider's Profile

Full Name	Russell Edward Proffitt
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	10 Years
Location	2601 N John B Dennis Hwy, Kingsport, Tennessee
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Russell Edward Proffitt graduated from nursing school in 2014

NPI Data:

NPI Number: 1124440128
Provider Enumeration Date: 01/09/2014
Last Update Date: 05/06/2014

Medicare PECOS Information:

PECOS PAC ID: 6507099710
Enrollment ID: I20140423001671

Medical Identifiers

Medical identifiers for Russell Edward Proffitt such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124440128	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	18164 (Tennessee)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Southeastern Surgical, Llc	7911393509	8

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. Russell Edward Proffitt allows following entities to bill medicare on his behalf.

Entity Name	American Anesthesiology Of Tennessee Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609822998 PECOS PAC ID: 9931001922 Enrollment ID: O20040713001364

Entity Name	Wellmont Medical Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780986257 PECOS PAC ID: 8123291739 Enrollment ID: O20111026000909

Entity Name	Southeastern Surgical, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326796426 PECOS PAC ID: 7911393509 Enrollment ID: O20220520002345

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. Russell Edward Proffitt 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
Russell Edward Proffitt, CRNA, RN, BSN 2601 N John B Dennis Hwy, Apt. 1001, Kingsport, TN 37660-0812 Ph: (423) 315-9306	Russell Edward Proffitt, CRNA, RN, BSN 2601 N John B Dennis Hwy, Apt. 1001, Kingsport, TN 37660-0812 Ph: (423) 315-9306

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Kingsport, TN

Mrs. Stacey Ann Ryder, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 130 W Ravine Rd, Kingsport, TN 37660 Phone: 423-224-4000
Jeffry M Holweger, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4128 Fort Henry Dr # D-226, Kingsport, TN 37663 Phone: 423-426-2121
Geena Sollecito, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 10415 Wallace Alley St, Kingsport, TN 37663 Phone: 423-390-0451
Jeri L Holweger, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4128 Fort Henry Dr # D-226, Kingsport, TN 37663 Phone: 423-426-2122
Mrs. Katherine A Miller, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2000 Brookside Dr, Kingsport, TN 37660 Phone: 423-857-7144
Bethany Kossick Seale, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 130 W Ravine Rd, Kingsport, TN 37660 Phone: 423-224-5711
Sandra J White, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2000 Brookside Dr, Kingsport, TN 37660 Phone: 423-857-7000

Russell Edward Proffitt, CRNA, RN, BSN - Medicare Certified Registered Nurse Anesthetist (crna) in Kingsport, TN