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NPI Code Detail

MEDICARE: JAMES AUSTIN RUSSELL AGACNP

MEDICARE: JAMES AUSTIN RUSSELL AGACNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner31786SC

General Provider Information

NPI Number : 1952288607
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES AUSTIN RUSSELL AGACNP
Provider Business Mailing Address
First Line : 303 E WOOD ST
Second Line :
City : SPARTANBURG
State : SC
Zip : 29303-3020
Country : US
Telephone Number : 864-560-4002
Fax Number :
Provider Business Practice Location Address
First Line : 303 E WOOD ST
Second Line :
City : SPARTANBURG
State : SC
Zip : 29303-3020
Country : US
Telephone Number : 864-560-4002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2025
Last Update Date : 06/02/2026

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