Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kim L Russell, PAC

Individual provider Dermatology Physician · NPI 1528136900

Kim L Russell, PAC is a Physician Assistant in Atlanta, Georgia. Qualified in 1991, 35 years ago. Practices with The Southeast Permanente Medical Group, a 826-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
35
Licensed in
GA
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

2525 Cumberland Pkwy SE Dept OF Dermatology
Atlanta, GA 30339-3915
Phone: (770) 431-4330
Fax: (770) 431-4193
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 002298 (GA)

Record details

NPI number1528136900
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedDecember 1, 2006
Last updated in NPPESJanuary 6, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Group practice The Southeast Permanente Medical Group — 826 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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