Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kassie Russom, PA-C

Individual provider Physician Assistant · NPI 1194315572

Kassie Russom, PA-C is a Physician Assistant in Charleston, South Carolina. Qualified in 2020, 6 years ago. Practices with Hospital Medicine Services of Tn LLC, a 273-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
6
Licensed in
SC
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

316 Calhoun St
Charleston, SC 29401-1113
Phone: (843) 724-2450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3982 (SC)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1194315572
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 20, 2021
Last updated in NPPESJuly 11, 2022
Certification dateJuly 11, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Hospital Medicine Services Of Tn Llc — 273 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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