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

Mr. Keith Wesley Fort, PA-C

Individual provider Physician Assistant · NPI 1487888061

Mr. Keith Wesley Fort, PA-C is a Physician Assistant in Jonesboro, Georgia. Qualified in 2008, 18 years ago. Practices with The Southeast Permanente Medical Group, a 826-clinician group and accepts Medicare assignment. Licensed in Georgia and New Jersey.

Years since qualifying
18
Licensed in
GA, NJ
In the registry since
2009
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2400 Mount Zion Pkwy Kaiser Permanente Southwood Medical Ctr
Jonesboro, GA 30236-2500
Phone: (201) 943-9100
Fax: (201) 943-7308
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 006400 (GA)
Physician Assistant Taxonomy 363A00000X · Licence 6400 (GA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 25MP00214500 (NJ)

Record details

NPI number1487888061
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 11, 2009
Last updated in NPPESJanuary 10, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice The Southeast Permanente Medical Group — 826 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Jonesboro