Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kenneth Wayne Edmisson Jr., NDEDDRNCFNPCRNA

Individual provider Family Nurse Practitioner · NPI 1295731081

Dr. Kenneth Wayne Edmisson Jr., NDEDDRNCFNPCRNA is a 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

Practice location Address checks out

225 Medical Center Dr #405
Paducah, KY 42003-7914
Phone: (270) 441-4750
Show map & directions

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

Other providers in Paducah