KANDALA WISE (FNP) – Family Nurse Practitioner, NPI 1114739182
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,664 NURSE PRACTITIONER in TN
Provider Addresses for KANDALA WISE (FNP)
314 BEE FARM RD
LEXINGTON, TN 383516152
Phone: (731) 614-9713
Type: Mailing
720 W FOREST AVE
JACKSON, TN 383013904
Phone: (731) 541-1700
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: 2025-06-11
PECOS data refreshed: 2026-05-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250611001226 | I | Nurse Practitioner | TN | TBD |
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.
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 38351)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | VA | |
| Nurse Practitioner | TN | |
| Hematology/Oncology, Medical Oncology, Hematology | TN | |
| Infectious Disease, Internal Medicine | TN | |
| - | TN | |
| Nurse Practitioner | TN | |
| Gynecological Oncology, Obstetrics/Gynecology | TN | |
| Interventional Radiology, Diagnostic Radiology | MI | |
| Diagnostic Radiology | TN | |
| Pulmonary Disease, Critical Care (Intensivists) | MO |
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