Carson Kisner, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

60769 Issued in TN

Practice address

60 Physicians Dr
Jackson, TN 38305-2070

Phone

(731) 240-1747

Fax

(731) 240-1755

NPI assigned

Apr 15, 2014

Last updated

Jul 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Interventional RadiologyAlso: Diagnostic Radiology

Education

University of Mississippi School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians

Jackson Madison County General HospitalGroup PAC ID 3678481975, 55 clinicians

Jackson Radiology Associates PAGroup PAC ID 6305893231, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• Volunteer Community Hospital Hospital, Martin, TN, CCN 440061
• West Tennessee Healthcare Camden Hospital Hospital, Camden, TN, CCN 441316
• West Tennessee Healthcare Milan Hospital Hospital, Milan, TN, CCN 440060
• West Tennessee Healthcare Bolivar Hospital Hospital, Bolivar, TN, CCN 441320

Merit-based Incentive Payment System (MIPS)

Final score

80.15 of 100Reported as group

Quality

74.15

Promoting interoperability

77

Improvement activities

40

Cost

78.84

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

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.

• Jackson Clinic PA

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1285629386
  Medicare reassignment Care Compare group NPD
• Jackson Madison County General Hospital

  dba JMCGH Radiology Professional

  • Diagnostic Radiology Physician
  • Jackson, TN
  • NPI 1891687208
  Medicare reassignment Care Compare group NPD
• Jackson Radiology Associates PA

  • Diagnostic Radiology Physician
  • Jackson, TN
  • NPI 1699700716

  Vascular & Interventional Radiology

  Medicare reassignment Care Compare group NPD
• Jackson Clinic PA

  dba Jackson Clinc PA DME

  • Durable Medical Equipment & Medical Supplies
  • Jackson, TN
  • NPI 1689443038
  NPD
• Professional Imaging of Tennessee

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Somerville, TN
  • NPI 1073569901
  NPD

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

• Bolivar General Hospital, Inc.

  dba West Tennessee Healthcare Bolivar Hospital

  • Critical Access Hospital
  • Bolivar, TN
  • NPI 1518957950
  Care Compare affiliation
• Camden General Hospital, Inc.

  dba West Tennessee Healthcare Camden Hospital

  • Critical Access Hospital
  • Camden, TN
  • NPI 1659347920
  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation
• Martin Health

  dba West Tennessee Healthcare Volunteer Hospital

  • General Acute Care Hospital
  • Martin, TN
  • NPI 1275505372
  Care Compare affiliation
• Milan General Hospital, Inc.

  dba West Tennessee Healthcare Milan Hospital

  • General Acute Care Hospital
  • Milan, TN
  • NPI 1699765453
  Care Compare affiliation

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1235558537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-240-1747",
            "fax_number": "731-240-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-240-1747",
            "fax_number": "731-240-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISNER",
        "first_name": "CARSON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "60769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Kay Kirk, RN
• Troy Alan Kirkendol, PHARM.D.
• William Todd Kirkendol, ATC, LAT
• Ronald H Kirkland, MD
• Brian Joseph Kirkpatrick, PTA
• Darleen Kitchen, LMT
• KKT Mobile Solutions LLC
• Ashada F Knight, MD
• Cameron Dewayne Knight, M.D.
• Carly Nicole Knight, BCBA

• Vascular & Interventional Radiology Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Vascular & Interventional Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.