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RUSSELL TREVENA MD
NPI 1679505762
Pediatrics - Pediatric Emergency Medicine in Stockbridge, GA

Active since July 07, 2006PECOS Enrolled
1510 HUDSON BRIDGE RD, STOCKBRIDGE, GA 30281(404) 785-8660(404) 785-8730 Get Directions Write a Review

NPPES record last updated: June 6, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 6, 2022, Jun 25, 2021 (2 updates tracked since 2021).

About Russell Trevena Md NPPES

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

RUSSELL TREVENA MD (NPI 1679505762) is an individual pediatric emergency medicine provider in Stockbridge, Georgia, licensed in Georgia (39251) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679505762
Entity TypeIndividualMale
Primary Taxonomy2080P0204X
Provider Legal NameRUSSELL TREVENACredential: MD
Location Address1510 HUDSON BRIDGE RDStockbridge, GA 30281-5020
Mailing Address1510 Hudson Bridge RdStockbridge, GA 30281-5020 · (404) 785-8660 · Fax (404) 785-8730
Phone(404) 785-8660
Fax(404) 785-8730
Sole ProprietorNo
Enumeration DateJuly 7, 2006
Last NPPES UpdateJune 6, 20222 updates tracked since enumeration
✔ NPI 1679505762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in GA · 39251
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
1510 HUDSON BRIDGE RD, Stockbridge, GA 30281
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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)

Russell Trevena Md 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.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TANYA GEHA M.D.
Pediatrics
1510 HUDSON BRIDGE RD
STOCKBRIDGE, GA 30281
Henry County (404) 785-8660
ASHLEY SHIM
Pediatrics
1510 HUDSON BRIDGE RD
STOCKBRIDGE, GA 30281
Henry County (404) 785-8660
DR. KEREN ZOHAR LANDMAN M.D.
Internal Medicine (Infectious Disease)
1510 HUDSON BRIDGE RD, C/O CHILDREN'S HEALTHCARE OF ATLA
STOCKBRIDGE, GA 30281
Henry County (404) 785-8660
JILL DANA MILLER M.D.
Pediatrics (Pediatric Emergency Medicine)
1510 HUDSON BRIDGE RD
STOCKBRIDGE, GA 30281
Henry County (404) 785-8660
JENNIFER YOUNGBLOOD MD
Pediatrics
1510 HUDSON BRIDGE RD
STOCKBRIDGE, GA 30281
Henry County (404) 785-8660
MAXEY MCNEESE HEBERT MD
Pediatrics
1510 HUDSON BRIDGE RD
STOCKBRIDGE, GA 30281
Henry County (404) 785-8660
NAJAZ WOODS-BISHOP MD
Pediatrics
1510 HUDSON BRIDGE RD
STOCKBRIDGE, GA 30281
Henry County (404) 785-8660
LATIKA GOYAL-SINGH MD
Pediatrics (Pediatric Emergency Medicine)
1510 HUDSON BRIDGE RD
STOCKBRIDGE, GA 30281
Henry County (404) 785-8660

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 Russell Trevena's NPI number?

The NPI number for Russell Trevena is 1679505762. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Where is Russell Trevena located?

Russell Trevena practices at 1510 Hudson Bridge Rd, Stockbridge, GA 30281. The listed phone number is (404) 785-8660.

What is Russell Trevena's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Russell Trevena enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Russell Trevena was last updated on June 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.