MR. KEITH WESLEY FORT (PA-C) – Physician Assistant, NPI 1487888061
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for MR. KEITH WESLEY FORT (PA-C)
2400 MT. ZION PARKWAY
KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER
JONESBORO, GA 30236
Phone: (201) 943-9100
Fax: (201) 943-7308
Type: Location
3495 PIEDMONT RD NE
NINE PIEDMONT CENTER
ATLANTA, GA 303051717
Phone: (404) 504-5678
Fax: (201) 862-0095
Type: Mailing
Piedmont Road Northeast, Buckhead, Atlanta, Georgia, 30305, United States
NINE PIEDMONT CENTER
ATLANTA, GA 30305
Phone: (404) 504-5678
Fax: (201) 862-0095
Type: Mailing
2400 MOUNT ZION PKWY
KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER
JONESBORO, GA 302362500
Phone: (201) 943-9100
Fax: (201) 943-7308
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-05-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120514000406 | I | Physician Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 23 | 12 | $0 |
Insurance plans in this area (ZIP 30236)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O S U R G E R Y | FL | |
| Internal Medicine | MA | |
| Family Practice | MN | |
| Family Practice | GA | |
| - | CA | |
| Pain Management | GA | |
| Internal Medicine | MA | |
| - | OH | |
| Internal Medicine | MA | |
| Orthopedic Surgery | FL |
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