Khaisha Verdelle Gist, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD0000057747 Issued in TN

Practice address

741 President PL Ste 140
Smyrna, TN 37167-6808

Phone

(615) 412-9013

Fax

(615) 307-4064

NPI assigned

Apr 21, 2015

Last updated

Aug 22, 2026By the provider in NPPES

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 2

Other names 1

• Dr. Khaisha Verdelle Johnson Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hyde Park Medical Group, PLLC

  dba Hyde Park Medical

  • Family Medicine Physician
  • Smyrna, TN
  • NPI 1043903990

  Single Specialty

  Medicare reassignment NPD Authorized official
• Hyde Park Medical Group, PLLC

  • Family Medicine Physician
  • Nashville, TN
  • NPI 1598455123

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787356800000",
    "number": "1184011835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "GLADEVILLE",
            "state": "TN",
            "postal_code": "370710023",
            "telephone_number": "615-412-9018",
            "fax_number": "615-307-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 PRESIDENT PL STE 140",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676808",
            "telephone_number": "615-412-9013",
            "fax_number": "615-307-4064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2723 New Salem Hwy",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371285253",
            "country_code": "US",
            "telephone_number": "615-410-9360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3939 Central Pike",
            "address_purpose": "LOCATION",
            "city": "Hermitage",
            "state": "TN",
            "postal_code": "370763499",
            "country_code": "US",
            "telephone_number": "615-883-2331",
            "fax_number": "615-391-1785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5380 Hickory Hollow Pkwy Ste 205",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "TN",
            "postal_code": "370133389",
            "country_code": "US",
            "telephone_number": "615-412-8662",
            "fax_number": "615-270-2493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIST",
        "first_name": "KHAISHA",
        "middle_name": "VERDELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-21",
        "last_updated": "2026-08-22",
        "certification_date": "2026-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "57747",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000057747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENT/TRAINING PROGRAM",
            "identifier": "1184011835",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "MD0000057747",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KHAISHA",
            "last_name": "JOHNSON",
            "middle_name": "VERDELLE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca Anne Gilbert, PA-C
• Hayley Gilliam, APN, FNP-BC
• Meris Gilliam
• Quantasia Gilliam, MS, CCC-SLP
• Stephanie Giron
• Joshua Gitsham
• Ebony Gladden
• Kaitlyn Glasscock, DMD
• Renee L. Glenn, M.D.
• Miller Goan

• Family Medicine Physician in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.