Individual provider Active NPI

Keliea Ann Winstead, PA-C

  • Medical Physician Assistant
  • McKenzie, TN
National Provider Identifier
1003353699
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3201 Issued in TN
Practice address
205A Hospital Dr
MC Kenzie, TN 38201-1649
Phone
(731) 352-7907
NPI assigned
Jan 21, 2017
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3201 TN Primary

Addresses

Primary practice location

205A Hospital Dr
MC Kenzie, TN 38201-1649

Mailing address

205A Hospital Dr
MC Kenzie, TN 38201-1649
Phone (731) 352-7907

Other practice location 1

205A Court Sq
Huntingdon, TN 38344-3710
Phone (731) 535-5765

Other practice location 2

1731 S Meridian St
Greenfield, TN 38230-1827
Phone (731) 678-0055

Other practice location 3

205C Hospital Dr
Mc Kenzie, TN 38201-1649
Phone (731) 207-8560

Other practice location 4

306 Highway 641 N
Camden, TN 38320-3012
Phone (731) 213-2344

Other practice location 5

811 Morrow St Ste 207
Dresden, TN 38225-1847
Phone (731) 364-4900

Other practice location 6

1894 Cedar St
Mc Kenzie, TN 38201-2206
Phone (731) 207-6496

Other practice location 7

105 N Cedar St
Gleason, TN 38229-7264
Phone (731) 648-5634

Other names 1

  • Miss Keliea Sullivan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20171121002354 TN Practitioner - Physician Assistant 2163789462 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McKenzie Medical Center PCGroup PAC ID 2365427853, 32 clinicians

Practice addresses (Care Compare)

105 N Cedar St
Gleason, TN 38229-7264
Phone (731) 648-5634

1731 S Meridan St
Greenfield, TN 38230-1827
Phone (731) 352-7907

1894 Cedar St
MC Kenzie, TN 38201-2206
Phone (731) 352-7907

205 A Court SQ
Huntingdon, TN 38344-3710
Phone (731) 352-7907

205 A Hospital Dr
MC Kenzie, TN 38201-2024
Phone (901) 352-7907

205 Hospital Dr
Suite a
MC Kenzie, TN 38201-2024

205 Hospital Dr
Suite C
MC Kenzie, TN 38201-1649
Phone (731) 352-7907

811 Morrow St
Suite 207
Dresden, TN 38225-1847
Phone (731) 364-4900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3201TNMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Medical Center PC CurrentSince Nov 7, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Mar 3, 2018 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Mar 3, 2018 Accepting new patients
McKenzie Medical Center PC Physician Assistant Current Accepting new patients
McKenzie Medical Center PC CurrentSince Nov 7, 2024 Accepting new patients
McKenzie Medical Center PC Physician Assistant Past Accepting new patients
McKenzie Medical Center, PC Physician Assistant Past Accepting new patients

Locations

30810 Broad St
Bruceton, TN 38317
Phone (731) 586-4800

306 Highway 641 N
Camden, TN 38320
Phone (731) 213-2344

306 Highway 641 N
Ste A
Camden, TN 38320

811 Morrow St
Ste 207
Dresden, TN 38225
Phone (731) 364-4900

105 N Cedar St
Gleason, TN 38229
Phone (731) 648-5634

205 Court Sq
#A
Huntingdon, TN 38344
Phone (731) 535-5765

1894 Cedar St
Mc Kenzie, TN 38201
Phone (731) 207-6496

205 Hospital Dr
Ste A
Mc Kenzie, TN 38201
Phone 7313527907 ext. 429

205 Hospital Dr
Ste C
Mc Kenzie, TN 38201
Phone (731) 207-8560

205C Hospital Dr
Mc Kenzie, TN 38201
Phone (731) 352-0820

Interoperability endpoints

  • Direct secure messaging: kwinstead578904@direct.bmhcc.org

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1484956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1003353699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205A HOSPITAL DR",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205A HOSPITAL DR",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205A Court Sq",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "TN",
            "postal_code": "383443710",
            "country_code": "US",
            "telephone_number": "731-535-5765",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1731 S Meridian St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "TN",
            "postal_code": "382301827",
            "country_code": "US",
            "telephone_number": "731-678-0055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205C Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382011649",
            "country_code": "US",
            "telephone_number": "731-207-8560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "306 Highway 641 N",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "TN",
            "postal_code": "383203012",
            "country_code": "US",
            "telephone_number": "731-213-2344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 Morrow St Ste 207",
            "address_purpose": "LOCATION",
            "city": "Dresden",
            "state": "TN",
            "postal_code": "382251847",
            "country_code": "US",
            "telephone_number": "731-364-4900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1894 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382012206",
            "country_code": "US",
            "telephone_number": "731-207-6496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 N Cedar St",
            "address_purpose": "LOCATION",
            "city": "Gleason",
            "state": "TN",
            "postal_code": "382297264",
            "country_code": "US",
            "telephone_number": "731-648-5634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINSTEAD",
        "first_name": "KELIEA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-21",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "3201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELIEA",
            "last_name": "SULLIVAN",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in McKenzie, TN

Sources for this page

Verify at the official NPI Registry.