MRS. CAROL D RUSSELL PA-C
NPI 1336134865
Physician Assistant - Medical in Viera, FL

Q: What is Carol Russell's NPI number?

The NPI number for Carol Russell is 1336134865. It was assigned to this individual provider in the NPPES registry on September 12, 2005.

Q: What is Carol Russell's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Carol Russell was last updated on January 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 12, 2005PECOS Enrolled

SPACE COAST VOLUNTEERS IN MEDICINE, 2555 JUDGE FRAN JAMIESON WAY, VIERA, FL 32940(321) 639-5813(321) 637-7312 Get Directions Write a Review

NPPES record last updated: January 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Mrs. Carol D Russell Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. CAROL D RUSSELL PA-C (NPI 1336134865) is an individual medical provider in Viera, Florida, licensed in Florida (LL861) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336134865

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMRS. CAROL D RUSSELLCredential: PA-C

Location AddressSPACE COAST VOLUNTEERS IN MEDICINE, 2555 JUDGE FRAN JAMIESON WAYViera, FL 32940

Mailing Address2555 Judge Fran Jamieson WayViera, FL 32940-5998 · (321) 639-5813 · Fax (321) 637-7312

Phone(321) 639-5813

Fax(321) 637-7312

Sole ProprietorNo

Enumeration DateSeptember 12, 2005

Last NPPES UpdateJanuary 26, 2024

NPPES CertifiedJanuary 26, 2024

✔ NPI 1336134865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Licenses✔ Licensed in FL · LL861✔ Licensed in FL · PA2709

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA2709 (FL)

SPACE COAST VOLUNTEERS IN MEDICINE, Viera, FL 32940

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Carol D Russell Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carol Russell's NPI number?

The NPI number for Carol Russell is 1336134865. It was assigned to this individual provider in the NPPES registry on September 12, 2005.

Where is Carol Russell located?

Carol Russell practices at Space Coast Volunteers In Medicine 2555 Judge Fran Jamieson Way, Viera, FL 32940. The listed phone number is (321) 639-5813.

What is Carol Russell's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Carol Russell enrolled in Medicare?

Yes. Carol Russell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carol Russell was last updated on January 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.