Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Dr. Kenneth Wayne Edmisson Jr., NDEDDRNCFNPCRNA

Individual provider Family Nurse Practitioner · NPI 1295731081

Dr. Kenneth Wayne Edmisson Jr., NDEDDRNCFNPCRNA is registered under Certified Registered Nurse Anesthetist (CRNA) in Paducah, Kentucky. Qualified in 2009, 17 years ago. Practices with Anesthesia Medical Group, PC, a 436-clinician group and accepts Medicare assignment. Licensed in Kentucky, Ohio, Tennessee and Texas and 1 more.

Years since qualifying
17
Licensed in
KY, OH, TN, TX, VA
In the registry since
2005
Specialties on file
6
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Practice location Address checks out

225 Medical Center Dr #405
Paducah, KY 42003-7914 Not confirmed with CMS for 15 years — call before visiting
Phone: (270) 441-4750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 6429 (TN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence APN0000006429 (TN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 0024162111 (VA)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 3007055 (KY)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 1659 (TX)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 12386-NA (OH)

Record details

NPI number1295731081
Entity typeIndividual (Type 1)
GenderMale
Credentials NDEDDRNCFNPCRNA
Sole proprietorYes
NPI enumeratedJune 26, 2005
Last updated in NPPESOctober 4, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Anesthesia Medical Group, P.C. — 436 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients147
Services billed 152 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

  • Tristar Horizon Medical Center Hospital · Dickson, TN

Colleagues at Anesthesia Medical Group, PC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 436 clinicians in the practice; 12 are shown here.

Other providers in Paducah