Kristin Erryn Russell, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

104196 Issued in NC

Practice address

1880 Quiet CV
Fayetteville, NC 28304-3857

Phone

(910) 323-2477

Fax

(910) 323-5931

NPI assigned

Jun 8, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristin-russell@cfcdd-net.e-mdsdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cape Fear Valley Health Medical Group LLC

  dba Cape Fear Orthopedics & Sports Medicine of Cape Fear Valley Health

  • Orthopaedic Surgery Physician
  • Fayetteville, NC
  • NPI 1235957655
  Medicare reassignment
• Cumberland County Hospital System Inc

  dba Oncology Services

  • Hematology & Oncology Physician
  • Fayetteville, NC
  • NPI 1881946242
  Medicare reassignment
• Premier Gastroenterology, PA

  • Specialist
  • Fayetteville, NC
  • NPI 1952306599
  Medicare reassignment
• Cumberland County Hospital System Inc

  dba CFV Primary Care-Robeson Family Practice

  • Family Medicine Physician
  • Red Springs, NC
  • NPI 1700552270
  NPD
• Cumberland County Hospital System Inc

  dba Cape Fear Valley Professional Radiology Group

  • Diagnostic Radiology Physician
  • Fayetteville, NC
  • NPI 1962299743
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1972544559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 QUIET CV",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043857",
            "telephone_number": "910-323-2477",
            "fax_number": "910-323-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 QUIET CV",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043857",
            "telephone_number": "910-323-2477",
            "fax_number": "910-323-5931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-4000",
            "fax_number": "910-323-3650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KRISTIN",
        "middle_name": "ERRYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "104196",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "104196",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA CERTIFICATE OF REGISTR",
            "identifier": "124919",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristin-russell@cfcdd-net.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "1880 Quiet Cv",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283043857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Russell-Gray, PA-C
• Laurie Rae Russell-Peabody, LCSWA, MSW, BSW
• Cynthia Reed Russell, NNP
• Fatia A Russell
• Kim Marie Russell, RRT
• Valerie Russell, LCSW-A
• Danielle S Rutherford, DO
• Katie Michelle Rutherford
• Bradley Ryan, D.D.S
• Ryan, James, Wiles, Patel & Olsen LLP (Cape Fear Oral Surgery)

• Medical Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.