Individual provider Active NPI

Kenedy McCade Sisson

  • Physician Assistant
  • Westmoreland, TN
National Provider Identifier
1104663657
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6740 Issued in TN
Practice address
1124 New Highway 52 E
Westmoreland, TN 37186-5032
Phone
(615) 644-2000
NPI assigned
Jul 11, 2024
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6740 TN Primary

Addresses

Primary practice location

1124 New Highway 52 E
Westmoreland, TN 37186-5032

Mailing address

1124 New Highway 52 E
Westmoreland, TN 37186-5032
Phone (615) 644-2000

Other practice location 1

300 Steam Plant Rd Ste 210
Gallatin, TN 37066-3060
Phone (615) 644-0509

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
I20251119004984 TN Practitioner - Physician Assistant 9739671587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Mississippi School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope Family Health ServicesGroup PAC ID 1658326194, 22 clinicians

Practice addresses (Care Compare)

1124 New Hwy 52 E
Westmoreland, TN 37186-5060
Phone (615) 644-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6740TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Family Health Services Physician Assistant CurrentSince Oct 29, 2025 Accepting new patients
Trevecca Nazarene University PastSince Jul 21, 2024 Accepting new patients

Locations

300 Steam Plant Rd
Ste 210
Gallatin, TN 37066
Phone (615) 328-3700

1124 New Highway 52 E
Westmoreland, TN 37186
Phone (615) 644-2000

1124 New Highway 52 E
Ste 420
Westmoreland, TN 37186

12124 Highway 52 W
Ste 5
Westmoreland, TN 37186
Phone (615) 644-2000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDEACA/Endpoint/DDEACA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1104663657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 NEW HIGHWAY 52 E",
            "city": "WESTMORELAND",
            "state": "TN",
            "postal_code": "371865032",
            "telephone_number": "615-644-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 NEW HIGHWAY 52 E",
            "city": "WESTMORELAND",
            "state": "TN",
            "postal_code": "371865032",
            "telephone_number": "615-644-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Steam Plant Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Gallatin",
            "state": "TN",
            "postal_code": "370663060",
            "country_code": "US",
            "telephone_number": "615-644-0509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISSON",
        "first_name": "KENEDY",
        "middle_name": "MCCADE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmoreland, TN

Sources for this page

Verify at the official NPI Registry.