KELLY RUSSIN PA
NPI 1780745554
Physician Assistant in Union City, GA

Q: What is Kelly Russin's NPI number?

The NPI number for Kelly Russin is 1780745554. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Q: What is Kelly Russin's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Russin was last updated on July 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 December 13, 2006PECOS EnrolledAccepts Medicare Assignment

6325 SHANNON PKWY, SUITE D, UNION CITY, GA 30291(770) 964-1400(770) 306-1343 Get Directions Write a Review

NPPES record last updated: July 26, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kelly Russin Pa NPPES

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

KELLY RUSSIN PA (NPI 1780745554) is an individual physician assistant in Union City, Georgia, licensed in Georgia (004096) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS, is affiliated with Southern Regional Medical Center, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1780745554

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLY RUSSINCredential: PA

Location Address6325 SHANNON PKWY, SUITE DUnion City, GA 30291-1538

Mailing Address6325 Shannon Pkwy, Suite DUnion City, GA 30291-1538 · (770) 964-1400 · Fax (770) 306-1343

Phone(770) 964-1400

Fax(770) 306-1343

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateDecember 13, 2006

Last NPPES UpdateJuly 26, 2012

✔ NPI 1780745554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in GA · 004096

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

6325 SHANNON PKWY, Union City, GA 30291

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Other Identifiers 2

Medicare UPINP99038

Medicare ID-Type Unspecified97WCFBW

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Russin Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446426217

PECOS Enrollment IDI20111228000258

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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

161 services81 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

31 services31 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

28 services19 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

16 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Southern Regional Medical Center

Acute Care Hospitals · Riverdale, GA

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110165

Location11 Upper Riverdale Road, SWRiverdale, GA 30274 · Clayton County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30291 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

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

DR. JON P COX D.O.

Family Medicine