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KANDALA WISE FNP
NPI 1114739182
Nurse Practitioner - Family in Jackson, TN

Active since January 24, 2025PECOS EnrolledAccepts Medicare Assignment
720 W FOREST AVE, JACKSON, TN 38301(731) 541-1700 Get Directions Write a Review

NPPES record last updated: January 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kandala Wise Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KANDALA WISE FNP (NPI 1114739182) is an individual family provider in Jackson, Tennessee, licensed in Tennessee (38054) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS, is affiliated with Jackson-madison County General Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1114739182
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKANDALA WISECredential: FNP
Location Address720 W FOREST AVEJackson, TN 38301-3904
Mailing Address314 Bee Farm RdLexington, TN 38351-6152 · (731) 614-9713
Phone(731) 541-1700
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 24, 2025
NPPES CertifiedJanuary 24, 2025
✔ NPI 1114739182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 38054
720 W FOREST AVE, Jackson, TN 38301
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kandala Wise Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1557871209
PECOS Enrollment IDI20250611001226
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jackson-Madison County General Hospital

Acute Care Hospitals · Jackson, TN
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440002
Location620 Skyline DriveJackson, TN 38301 · Madison County
Emergency services Birthing friendly

Volunteer Community Hospital

Acute Care Hospitals · Martin, TN
4/5 CMS rating
OwnershipProprietary
CMS Certification Number440061
Location161 Mount Pelia RdMartin, TN 38237 · Weakley County
Emergency services Birthing friendly

Dyersburg Regional Medical Center

Acute Care Hospitals · Dyersburg, TN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number440072
Location400 East Tickle StreetDyersburg, TN 38024 · Dyer County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RUTH LYN WELLS PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
720 W FOREST AVE
JACKSON, TN 38301
Madison County (731) 541-1495
JESSICA DAUNE RICH DAVIS D.O.
Internal Medicine (Hematology & Oncology)
720 W FOREST AVE
JACKSON, TN 38301
Madison County (731) 541-9561
SAIRA FARID MD
Internal Medicine (Hematology & Oncology)
720 W FOREST AVE
JACKSON, TN 38301
Madison County (731) 541-5087
MRS. MARY MURPHY MCMILLIN APN
Nurse Practitioner
720 W FOREST AVE
JACKSON, TN 38301
Madison County (731) 541-9561

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kandala Wise's NPI number?

The NPI number for Kandala Wise is 1114739182. It was assigned to this individual provider in the NPPES registry on January 24, 2025.

Where is Kandala Wise located?

Kandala Wise practices at 720 W Forest Ave, Jackson, TN 38301. The listed phone number is (731) 541-1700.

What is Kandala Wise's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kandala Wise enrolled in Medicare?

Yes. Kandala Wise is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kandala Wise accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 4 other insurers list Kandala Wise as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kandala Wise affiliated with any hospitals?

According to CMS data, Kandala Wise is affiliated with Jackson-Madison County General Hospital, Volunteer Community Hospital and Dyersburg Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Kandala Wise was last updated on January 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.