AMANDA RUSSELL – Family Medicine Physician, NPI 1114312295

AMANDA RUSSELL is a healthcare provider. based in Dinwiddie, Virginia. specializing in FAMILY PRACTICE. They hold a License No. 0101264538 (VA). The NPI Number for AMANDA RUSSELL is 1114312295

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA RUSSELL
NPI
1114312295
Phone
Not provided
Address
13855 COURTHOUSE RD
Enumeration Date
5 April 2015
Last Update Date
15 July 2024

Doctor Profile

Medical School Name
EASTERN VIRGINIA MEDICAL SCHOOL
Secondary Phone
8044693731
Graduation Year
2015 (11 years ago)
PAC ID
6709193469
Group Practice PAC ID
0648188755
Professional Enrollment ID
I20180919002068
Address ID
VA238412254DI13855RDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

3,174 FAMILY PRACTICE in VA

Provider Addresses for AMANDA RUSSELL

  • 13855 COURTHOUSE RD

    DINWIDDIE, VA 238412254

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $34.

Total Amount is formed as General ($34) + Research ($0) + Ownership ($0) = $34.

Last reported payment date: 2024-04-12 • Largest payer in this snapshot: PFIZER INC. ($17).

Total Amount

$34

General + Research + Ownership

Payments

2

Total payment records

General Amount

$34

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-12

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-09-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180919002068IFamily PracticeVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
83036Hemoglobin a1c level7435$0
81003Automated urinalysis test2015$0
71046X-ray of chest, 2 views1111$0
View full utilization report →

Insurance plans in this area (ZIP 23841)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648188755View full group profile
NameSpecialtyState
Family PracticeGA
Pediatric Medicine, Emergency MedicineVA
Internal Medicine, Pediatric MedicineVA
Family PracticeVA
Nurse PractitionerVA
Nurse PractitionerVA
Physician AssistantVA
Nurse PractitionerVA
Clinical Social WorkerVA
Family PracticeVA

Reviews

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Frequently asked questions

What unique ID ties claims to AMANDA RUSSELL?
NPI 1114312295 is assigned to AMANDA RUSSELL under the national enumeration system.
Is AMANDA RUSSELL currently active in the NPI registry?
CMS-published data lists AMANDA RUSSELL as an active registrant.
Can you summarize AMANDA RUSSELL's specialty in plain language?
Clinically, the directory lists AMANDA RUSSELL with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place AMANDA RUSSELL?
The snapshot lists Dinwiddie, Virginia for AMANDA RUSSELL; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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