Individual provider Active NPI

Kendall Sisk

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1619757275
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28524 Issued in SC
Practice address
1120 Grove Rd
Greenville, SC 29605-4656
Phone
(864) 455-8897
Fax
(864) 455-8555
NPI assigned
Oct 2, 2023
Last updated
Dec 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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 28524 SC Primary

Addresses

Primary practice location

1120 Grove Rd
Greenville, SC 29605-4656

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

1801 Sunset Dr Ste 200
Columbia, SC 29203-6803
Phone (803) 434-3020

Other names 1

  • Kendall Marie Sisk Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240920000943 SC Practitioner - Nurse Practitioner 8820539653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1120 Grove Rd
Greenville, SC 29605-4656
Phone (864) 455-8802

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28524SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Mar 23, 2025 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 22, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince Mar 23, 2025 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 22, 2024 Accepting new patients

Locations

1801 Sunset Dr
Columbia, SC 29203
Phone (803) 434-4153

1801 Sunset Dr
Ste 200
Columbia, SC 29203
Phone (803) 434-3020

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1120 Grove Rd
Greenville, SC 29605
Phone (864) 455-8802

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: kmoore514932@direct.ghs.myhfn.org

Organizations & group practices 4

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 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1619757275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054656",
            "telephone_number": "864-455-8897",
            "fax_number": "864-455-8555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Sunset Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036803",
            "country_code": "US",
            "telephone_number": "803-434-3020",
            "fax_number": "803-434-4155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISK",
        "first_name": "KENDALL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "28524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDALL",
            "last_name": "SISK",
            "middle_name": "MARIE",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.