Individual provider Active NPI

Kayla Lanee Dedman

  • Family Nurse Practitioner
  • Lebanon, TN
National Provider Identifier
1235886755
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
31150 Issued in TN
Practice address
204 Oak St
Lebanon, TN 37087-3334
Phone
(615) 840-1457
NPI assigned
Mar 4, 2022
Last updated
Apr 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 31150 TN Primary

Addresses

Primary practice location

204 Oak St
Lebanon, TN 37087-3334

Mailing address

1259 Inverness Pass
Lebanon, TN 37087
Phone (615) 840-1457

Other names 1

  • Ms. Kayla Lanee George 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
I20220610001637 TN Practitioner - Nurse Practitioner 3870971377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anova Medical Associates, PLCGroup PAC ID 8325372741, 130 clinicians

Practice addresses (Care Compare)

1156 Nashville Pike
Gallatin, TN 37066-3110
Phone (615) 989-1088

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31150TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anova Medical Associates, PLC CurrentSince Apr 13, 2022 Accepting new patients

Locations

1156 Nashville Pike
Gallatin, TN 37066
Phone (615) 989-1088

Interoperability endpoints

  • Direct secure messaging: kgann23203@direct.vumc.org

Organizations & group practices 1

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 1

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": "1646352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1235886755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 INVERNESS PASS",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-840-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 OAK ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873334",
            "telephone_number": "615-840-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDMAN",
        "first_name": "KAYLA",
        "middle_name": "LANEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-04",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "GEORGE",
            "middle_name": "LANEE",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.