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

Kali Renee Rutherford, PA

Individual provider Physician Assistant · NPI 1164275566

Kali Renee Rutherford, PA is a Physician Assistant in Jefferson Cty, Tennessee. Graduated from Lincoln Memorial University Medical Department in 2023, 3 years ago. Works from 3 locations. Licensed in Tennessee.

Years since qualifying
3
Trained at
Lincoln Memorial University Medical Department
Licensed in
TN
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

1405 S Sizer Ave Ste A
Jefferson Cty, TN 37760-2421
Phone: (865) 690-3811
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2707 Jacksboro Pike Ste 2, Jacksboro, TN 37757-2752 — (423) 437-8576
  • 7557 Dannaher Dr Ste 230, Powell, TN 37849-3563 — (865) 938-5222

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5906 (TN)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1164275566
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 8, 2024
Last updated in NPPESJune 5, 2026
Certification dateJune 5, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated