NPI age
17 years
Enumerated 2009-05-11
● Active
Type 1 · Individual
MR. Keith Wesley Fort, PA-C
Fort is 1 of 10 physician assistant providers in Jonesboro and 1 of 4616 in Georgia.
Primary specialty
Physician Assistant
Plus 2 subspecialties
Licensed in
GA, NJ
2 states
Status
Active
No deactivations on record
Last NPPES update
2022-01-10
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4616 active physician assistant providers in Georgia.
NPI age
17 years
↑ 9 yr above median (8 yr)
State licenses
2 states
Top 90% — 9% of peers are multi-state
Subspecialties
1
In the 24% of peers with subspecialties
NPI lifetime · 2009 → 2026
2009-05Enumerated in NPPES
2009
2026
Where they practice
Practice location
2400 Mount Zion Pkwy, Kaiser Permanente Southwood Medical Center
Jonesboro, GA 302362500
Mailing address
3495 Piedmont Rd Ne, Nine Piedmont Center
Atlanta, GA 303051717
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
-
Physician AssistantDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (NJ) | 162546NMS | MEDICARE PTAN |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 122 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.