Kerri Lu Leva Cisney, PA-C
Individual provider Active NPI Physician Assistant · Fayetteville, TN
NPI 1750685673 · NPPES record last updated Feb 26, 2025
Key facts
- NPI
- 1750685673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2444 (TN)
- Practice address
- 2330 Thornton Taylor Pkwy Ste B
Fayetteville, TN 37334-3673 - Phone
- (256) 539-2728
- Fax
- (256) 539-2666
- NPI assigned
- Jan 6, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- HH Health System - the Orthopaedic Center LLC
Practice addresses (Care Compare)
927 Franklin St SE
Huntsville, AL 35801-4305
Phone (256) 539-2728
Hospital & facility affiliations
- Lincoln Medical Center
- Huntsville Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AL, TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141001001530 | AL | Practitioner - Physician Assistant | 2365469319 | Reassigns benefits to 3 organizations |
| I20220923000537 | TN | Practitioner - Physician Assistant | 2365469319 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA975 | AL | MD | Surgical Physician Assistant |
Interoperability endpoints
- kerri.cisney.toc@toc.direct.systemedx.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA975 | AL | |
| Surgical Physician Assistant | 363AS0400X | PA975 | AL | |
| Physician Assistant | 363A00000X | 2444 | TN | Yes |
Addresses
Primary practice location
2330 Thornton Taylor Pkwy Ste B
Fayetteville, TN 37334-3673
Mailing address
927 Franklin St SE
Huntsville, AL 35801-4306
Phone (256) 539-2728
Other practice location 1
927 Franklin St SE
Huntsville, AL 35801-4306
Phone (256) 539-2728
Other providers in Fayetteville, TN
- Carters Inc
- Mary Causey
- Center for Physical Medicine
- Chiropractic Health Center
- Christopher E Gafford Dba Gafford Family Medicine
- Laura Clark
- Robert Lewis Clark
- Richard William Cline Jr.
- Rudy Theodore Cobb
- Colbert Family Densistry
All providers in Fayetteville, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.