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

Luke Andrew Russell, PA

Individual provider Physician Assistant · NPI 1407366453

Luke Andrew Russell, PA is a Physician Assistant in Columbia, South Carolina. Qualified in 2017, 9 years ago. Practices with Prisma Health Medical Group-Midlands, a 1,018-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Nebraska and South Carolina.

Years since qualifying
9
Licensed in
NE, SC
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Phone: (803) 434-1663
Fax: (803) 434-7092
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7050 Air Depot Blvd Bldg 1040, Tinker Afb, OK 73145-8716 — (405) 734-2778

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5749 (SC)
Physician Assistant Taxonomy 363A00000X (NE)

Record details

NPI number1407366453
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 4, 2017
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Prisma Health Medical Group-Midlands — 1018 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Columbia