KD Wainwright, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4330 Issued in TN

Practice address

403 Henslee Dr
Dickson, TN 37055-2166

Phone

(615) 637-3131

Fax

(931) 208-3616

NPI assigned

Sep 29, 2017

Sex

Female

Sole proprietor

No

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Elite Psychiatry of Tennessee LLCGroup PAC ID 2365811692, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aviata at Lake Mary Nursing home, Lake Mary, FL, CCN 106029

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Elite Psychiatry of Tennessee LLC

  • Physician Assistant
  • Dickson, TN
  • NPI 1023733557
  Medicare reassignment Care Compare group Authorized official
• Jupiter Medical Center Physicians Group Inc

  dba JMC Community Care

  • Pediatric Surgery Physician
  • Jupiter, FL
  • NPI 1093344376
  NPD
• Jupiter Medical Center Physicians Group Inc

  • Cardiovascular Disease Physician
  • Jupiter, FL
  • NPI 1396992475
  NPD (past)

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

• 710 N Sun Dr Opco LLC

  dba Aviata at Lake Mary

  • Skilled Nursing Facility
  • Lake Mary, FL
  • NPI 1003688318

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1326557646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 HENSLEE DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552166",
            "telephone_number": "615-637-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 HENSLEE DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552166",
            "telephone_number": "615-637-3131",
            "fax_number": "931-208-3616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 N Main St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Dickson",
            "state": "TN",
            "postal_code": "370551838",
            "country_code": "US",
            "telephone_number": "615-637-3131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5430 Military Trl",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334582873",
            "country_code": "US",
            "telephone_number": "561-263-7010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2550 SE Walton Rd",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "34952",
            "country_code": "US",
            "telephone_number": "772-335-0400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 SE Monterey Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349944512",
            "country_code": "US",
            "telephone_number": "772-419-0560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 N Main St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Dickson",
            "state": "TN",
            "postal_code": "370551838",
            "country_code": "US",
            "telephone_number": "615-637-3131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAINWRIGHT",
        "first_name": "KD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2024-07-25",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarod Vermeesch, PT, CSCS
• David Andrew Vincent, PA-C
• Chandni K Vyas
• Matthew Luke Wade, MFT
• Hazel Joyce Wadkins, CSFA
• Jeremiah Wakefield, PT
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0264)
• Wal-Mart Stores East, LP (Vision Center 30-0264)
• Cara Walden
• Mitchell Walden

• Physician Assistant in Dickson, TN
• Providers in Dickson, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.