DR. KHAISHA VERDELLE GIST (NPI# 1184011835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184011835 |
| Entity Type | Individual |
| Full Name | DR. KHAISHA VERDELLE GIST |
| Other Name | DR. KHAISHA VERDELLE JOHNSON |
| Credential | M.D. |
| Practice Address |
3939 Central Pike Hermitage TN 37076-3499 |
| Practice Telephone | 6158832331 |
| Practice Fax Number | 6153911785 |
| Mailing Telephone | 6158832331 |
| Mailing Fax Number | 6153911785 |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2018-11-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD0000057747 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | TN LICENSE | MD0000057747 | 01 |
| TN | RESIDENT/TRAINING PROGRAM | 1184011835 | 01 |
| Street Address |
3939 CENTRAL PIKE |
| City | HERMITAGE |
| State | TN |
| Zip Code | 37076-3499 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710968037 | Richard Y Pak | Family Medicine | 3939 Central Pike, Hermitage, TN 37076 | 2005-11-14 |
| 1538479688 | Demetria Edwards | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3499 | 2010-10-07 |
| 1023340809 | Michael Warren | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3499 | 2010-02-04 |
| 1225364748 | Amanda Sher Fallos | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3499 | 2009-10-19 |
| 1386712339 | Kari Hammer | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3410 | 2006-11-30 |
| 1255419255 | Summit Primary Care | Family Medicine | 3939 Central Pike, Hermitage, TN 37076-3499 | 2006-11-01 |
| 1295748408 | Kenneth Roy Henry | Physician Assistant | 3939 Central Pike, Hermitage, TN 37076-3499 | 2006-08-15 |
| 1508884875 | Matthew H Milligan | Family Medicine | 3939 Central Pike, Hermitage, TN 37076-3499 | 2006-07-17 |
| 1740225887 | Summit Primary Care | Non-Pharmacy Dispensing Site | 3939 Central Pike, Hermitage, TN 37076-3410 | 2006-06-20 |
| 1730161985 | Edward L King | Family Medicine | 3939 Central Pike, Hermitage, TN 37076 | 2005-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255996583 | Cassandra Renea Brown | Dietitian, Registered | 5653 Frist Blvd Suite 530, Hermitage, TN 37076 | 2019-05-02 |
| 1164979753 | Chelsea Douglas | Nurse Practitioner | 5565 Frist Boulevard, Hermitage, TN 37076 | 2016-09-01 |
| 1417333568 | Middle Tennessee Homes | Intermediate Care Facility, Mentally Retarded | 3207 Earhart Road, Hermitage, TN 37076 | 2015-07-30 |
| 1578944187 | Middle Tennesse Homes | Intermediate Care Facility, Mentally Retarded | 3209 Earhart Road, Hermitage, TN 37076 | 2015-06-10 |
| 1063835585 | Rachel Jane Morris | Occupational Therapist | 1621 Robindale Dr, Hermitage, TN 37076 | 2014-02-04 |
| 1427488154 | Earhart 1 | Intermediate Care Facility, Mentally Retarded | 3156 Earhart Rd, Nashville, TN 37076 | 2013-11-15 |
| 1669802393 | Tulip Grove #2 | Intermediate Care Facility, Mentally Retarded | 877 Tulip Grove Rd, Nashville, TN 37076 | 2013-11-15 |
| 1780014514 | Tulip Grove Road #1 | Intermediate Care Facility, Mentally Retarded | 869 Tulip Grove Rd, Nashville, TN 37076 | 2013-11-14 |
| 1215365440 | Hospital Based Medical Services of Tennessee-i PC | Physician Assistant | 5655 First Blvd, Hermitage, TN 37076 | 2013-10-25 |
| 1942545686 | Helping Hands Support Center, Inc. | Home Health | 4060 Andrew Jackson Pkwy #907, Hermitage, TN 37076 | 2012-12-06 |
| Find all providers in zip 37076 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124633672 | Upmc Community Medicine, Inc | Family Medicine | 3140 Highland Rd Ste 102, Hermitage, PA 16148-4514 | 2020-09-11 |
| 1780116806 | Kayla Milano | Family Medicine | 2425 Garden Way Ste 102, Hermitage, PA 16148-5215 | 2017-03-29 |
| 1558616532 | Willis Family Medical Center, P.C. | Family Medicine | 3441 Lebanon Pike Ste 101, Hermitage, TN 37076-2000 | 2012-07-17 |
| 1851402010 | Gordon Reed Wouters | Family Medicine | Hwy 254 & Dallas St., Hermitage, MO 65668 | 2006-08-31 |
| 1689639676 | Robert A Cicuto | Family Medicine | 2213 Shenango Valley Freeway, Hermitage, PA 16148 | 2006-04-20 |
| 1649247255 | Covenant Family Medicine | Family Medicine | 3110 Highland Rd, Suite 203, Hermitage, PA 16148-4505 | 2006-03-02 |
| 1386615540 | Cynthia L Wallace | Family Medicine | 4777 Andrew Jackson Pkwy, Suite 101, Hermitage, TN 37076-1356 | 2006-01-27 |
| 1932179389 | Gregory D. Witters | Family Medicine | 4777 Andrew Jackson Parkway, Suite 102, Hermitage, TN 37076 | 2006-01-26 |
| 1477533834 | William Joseph Herbert | Family Medicine | 3910 E State St, Hermitage, PA 16148-3405 | 2006-01-20 |
| 1710968037 | Richard Y Pak | Family Medicine | 3939 Central Pike, Hermitage, TN 37076 | 2005-11-14 |
| Find all providers in HERMITAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.