EXCLUDEDPROVIDER
Individual Revocation

Shirley Ann Montgomery

Lake Butler, FL 32054

Public HHS-OIG LEIE exclusion record

According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Shirley Ann Montgomery of Lake Butler, FL is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of April 20, 2020.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Lake Butler, FL 32054
Exclusion date
April 20, 2020
Exclusion type
Revocation (1128b4)
Source dataset
May 2026

Record summary

Shirley Ann Montgomery appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Lake Butler, Florida. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is April 20, 2020, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateApril 20, 2020
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Lake Butler, FL 32054. The listed provider category is Individual - Licensed Health Care Service Provider. The listed specialty is Nurse / Nurses Aide.

Other excluded providers in Lake Butler, FL

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Lake Butler, FL address.

Eric Lee Hursh Individual Drug Felony
Lake Butler, FL · Felony conviction relating to controlled substance · Excluded Oct 2022
Mark Raymond Miskar Individual Patient Abuse
Lake Butler, FL · Conviction relating to patient abuse or neglect · Excluded Mar 2022
Brien Morris Individual Drug Felony
Lake Butler, FL · Felony conviction relating to controlled substance · Excluded Jul 2017
David Vaughn Bledsoe Individual Program Crime
Lake Butler, FL · Conviction of program-related crimes · Excluded Aug 2016
Heath Durant Mcconnell Individual Drug Felony
Lake Butler, FL · Felony conviction relating to controlled substance · Excluded Feb 2008
Samuel Brallier Individual Program Crime
Lake Butler, FL · Conviction of program-related crimes · Excluded May 1999

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

Related

More Excluded Individuals in Florida More Records in Lake Butler More Revocation Records