Stephanie Keith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00311 Issued in MS

Practice address

1659 Lelia Dr
Jackson, MS 39216-4818

Phone

(601) 910-3004

Fax

(601) 910-3005

NPI assigned

Jan 26, 2017

Last updated

Jun 1, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Stanford Former name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Magnolia Dermatology, PLLCGroup PAC ID 0749576031, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health River Region Hospital, Vicksburg, MS, CCN 250031

Merit-based Incentive Payment System (MIPS)

Final score

78.38 of 100Reported as group

Quality

54.22

Promoting interoperability

100

Improvement activities

40

Cost

73.72

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Magnolia Dermatology, PLLC

  • Dermatology Physician
  • Clinton, MS
  • NPI 1841645470
  Medicare reassignment Care Compare group NPD
• Anesthesia Consultants PA

  • Anesthesiology Physician
  • Jackson, MS
  • NPI 1750300836
  NPD (past)
• Optical 2000

  • Optometrist
  • Clinton, MS
  • NPI 1144422577
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Vicksburg Healthcare LLC

  dba Merit Health River Region

  • General Acute Care Hospital
  • Vicksburg, MS
  • NPI 1215981303
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1023555190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 HIGHWAY 80 E",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565252",
            "telephone_number": "601-910-3004",
            "fax_number": "601-910-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 LELIA DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164818",
            "telephone_number": "601-910-3004",
            "fax_number": "601-910-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "STANFORD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Britiani Keen, FNP-C
• James E Keeton, MD
• Toni Lynne Keilers, DO
• Ansley Myers Keith
• John Keith, M.D.
• Alexander Kyle Kellar, MD
• Candace Keller, MD
• Adrianne Cronin Kelley, ANP-C
• Kimberly Kelley, NP
• Robert Mattthew Kelley Jr., MD

• Physician Assistant in Jackson, MS
• Providers in Jackson, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.