Individual Healthcare Provider
Kirk Shane Russell, M.D.
Provider's NPPES record last updated: January 31, 2025
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1912075631
- Primary Specialty
- Radiology — Vascular & Interventional Radiology
- Practice Location
- Fort Liberty, North Carolina
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 21, 2026, 3:41 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Radiology
Vascular & Interventional Radiology
Allopathic & Osteopathic Physicians
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Taxonomy code 2085R0204X Radiology
Diagnostic Radiology
Allopathic & Osteopathic Physicians
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Taxonomy code 2085R0202X
Provider-Reported License Information
- Radiology (North Carolina)
- 2014-02064
- Radiology (New York)
- 230324
- Radiology (North Carolina)
- 2014-02064
Practice Locations
Practice Location
Womack Army Medical Center 2817 Rock Merritt Ave
Fort Liberty, North Carolina 28310-6644
Phone: (910) 907-8707
Record Information
- Enumeration Date
- December 1, 2006
- Provider's NPPES Record Last Updated
- January 31, 2025
- Certification Date
- January 31, 2025
- NPISignal NPPES Dataset
- August 2026
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