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

Mr. Jeremy Lawrence Russell, PA-C

Individual provider Physician Assistant · NPI 1639808306

Mr. Jeremy Lawrence Russell, PA-C is a Physician Assistant in Hammond, Louisiana. Graduated from Louisiana State University School of Medicine in New Orleans in 2022, 4 years ago. Practices with North Oaks Medical Center LLC, a 311-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
4
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
LA
In the registry since
2022
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

15790 Paul Vega Md Dr
Hammond, LA 70403-1436
Phone: (985) 345-2700
Fax: (985) 230-6653
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 332993 (LA)
Physician Assistant Taxonomy 363A00000X · Licence 1196694 (LA)

Record details

NPI number1639808306
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 8, 2022
Last updated in NPPESJune 8, 2023
Certification dateJune 8, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2022 (4 years in practice)
Group practice North Oaks Medical Center Llc — 311 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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