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General NPI Number Information
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NPI Number | 1801740089
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Entity Type | Organization
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Legal Business Name | ROCKET CITY MEDICAL EVALUATION GROUP, LLC
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 806 GOVERNORS DR SW STE 207
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5133
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Country | US
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Telephone | 256-701-7188
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Fax |
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Provider Business Mailing Address
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Address Line | 29747 COPPERPENNY DR NW
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City | HARVEST
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State | AL
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Zip | 35749-7987
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | JASTIN RUSSELL
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Credential | DNP, CRNP, FNP-C
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Telephone | 256-701-7188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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