MISS KENEDY MCCADE SISSON – Physician Assistant, NPI 1104663657

MISS KENEDY MCCADE SISSON is a healthcare provider. based in Westmoreland, Tennessee. specializing in PHYSICIAN ASSISTANT. They hold a License No. 6740 (TN). The NPI Number for MISS KENEDY MCCADE SISSON is 1104663657

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
MISS KENEDY MCCADE SISSON
NPI
1104663657
Phone
(615) 644-2000
Address
1124 NEW HIGHWAY 52 E
Enumeration Date
11 July 2024
Last Update Date
24 November 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Secondary Phone
6156442000
Graduation Year
2018 (8 years ago)
PAC ID
9739671587
Group Practice PAC ID
1658326194
Professional Enrollment ID
I20251119004984
Address ID
TN371865060WE1124XEXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

3,134 PHYSICIAN ASSISTANT in TN

Provider Addresses for MISS KENEDY MCCADE SISSON

  • 1124 NEW HIGHWAY 52 E

    WESTMORELAND, TN 371865032

    Phone: (615) 644-2000

    Type: Mailing

  • 300 Steam Plant Rd Ste 210

    Gallatin, TN 370663060

    Phone: (615) 644-0509

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-19

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251119004984IPhysician AssistantTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37186)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658326194View full group profile
NameSpecialtyState
Nurse PractitionerKY
Physician AssistantTN
Nurse PractitionerTN
Nurse PractitionerTN
Mental Health CounselorKY
Nurse PractitionerTN
Mental Health CounselorTN
-TN
Nurse PractitionerTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

How is MISS KENEDY MCCADE SISSON identified in CMS data?
CMS-hosted NPPES data lists MISS KENEDY MCCADE SISSON with NPI 1104663657.
Can I rely on MISS KENEDY MCCADE SISSON being an active provider?
As of the registry snapshot, MISS KENEDY MCCADE SISSON is marked active.
What taxonomy line describes MISS KENEDY MCCADE SISSON?
For research purposes, treat MISS KENEDY MCCADE SISSON as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Does MISS KENEDY MCCADE SISSON list a practice location?
Patients near Westmoreland, Tennessee may find MISS KENEDY MCCADE SISSON in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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