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

Tracy Dewayne Kennemore, PT

Individual provider Physical Therapist · NPI 1972526515

Tracy Dewayne Kennemore, PT is a Physical Therapist in Private Practice in Kimball, Tennessee. Qualified in 1999, 27 years ago. Practices with Southern Rehab and Aquatics, a 5-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
27
Licensed in
TN
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

400 Dixie Lee Center Rd
Kimball, TN 37347-5672
Phone: (423) 837-7536
Fax: (423) 837-7538
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT0000006009 (TN)

Record details

NPI number1972526515
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedJuly 25, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Southern Rehab And Aquatics — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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