KRISTIN ERRYN RUSSELL PA-C
NPI 1972544559
Physician Assistant - Medical in Fayetteville, NC

Q: What is Kristin Russell's NPI number?

The NPI number for Kristin Russell is 1972544559. It was assigned to this individual provider in the NPPES registry on June 8, 2006.

Q: What is Kristin Russell's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Kristin Russell was last updated on May 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 08, 2006PECOS Enrolled

1880 QUIET CV, FAYETTEVILLE, NC 28304(910) 323-2477(910) 323-5931 Get Directions Write a Review

NPPES record last updated: May 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 28, 2026, May 4, 2026, Aug 19, 2020 (3 updates tracked since 2020).

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About Kristin Erryn Russell Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTIN ERRYN RUSSELL PA-C (NPI 1972544559) is an individual medical provider in Fayetteville, North Carolina, licensed in North Carolina (104196) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Fayetteville.

NPPES Registry Identity

NPI1972544559

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameKRISTIN ERRYN RUSSELLCredential: PA-C

Location Address1880 QUIET CVFayetteville, NC 28304-3857

Mailing Address1880 Quiet CvFayetteville, NC 28304-3857 · (910) 323-2477 · Fax (910) 323-5931

Phone(910) 323-2477

Fax(910) 323-5931

Sole ProprietorYes

Enumeration DateJune 8, 2006

Last NPPES UpdateMay 28, 20263 updates tracked since enumeration

NPPES CertifiedMay 28, 2026

✔ NPI 1972544559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in NC · 104196

Also ListedPhysician AssistantTaxonomy 363A00000X · License 104196 (NC)

1880 QUIET CV, Fayetteville, NC 28304

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Secondary Practice Location 1

Location 11638 Owen DrFayetteville, NC 28304-3424 · Phone (910) 615-4000 · Fax (910) 323-3650

Other Identifiers 1

Other124919NC · Pa Certificate Of Registr

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kristin Erryn Russell Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL CATHERINE KELLOMAKI PA-C

Physician Assistant