NPIMap

Individual provider Active NPI

Keith G Goodfellow, MD

  • Obstetrics & Gynecology Physician
  • Biloxi, MS
National Provider Identifier
1164573515
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
13840 Issued in MS
Practice address
147 Reynoir St Ste 105
Biloxi, MS 39530
Phone
(228) 436-6674
NPI assigned
Jan 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 13840 MS Primary

Addresses

Primary practice location

147 Reynoir St Ste 105
Biloxi, MS 39530

Mailing address

PO Box 321359
Flowood, MS 39232-1359
Phone (601) 936-1395

Other practice location 1

4577 13th St
Gulfport, MS 39501-2516
Phone (228) 864-2752

Other identifiers 1

IdentifierTypeStateIssuer
06474210MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080219000576 MS Practitioner - Obstetrics/Gynecology 8729162425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2465

147 Reynoir St
Biloxi, MS 39530-4119

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Feb 1, 2025 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Feb 1, 2025 Accepting new patients
Biloxi Hma Physician Management LLC Obstetrics & Gynecology CurrentSince Mar 1, 2023 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients
Biloxi Hma LLC Past Accepting new patients

Locations

147 Reynoir St
Ste 105
Biloxi, MS 39530
Phone (228) 435-9365

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

4577 13th St
Gulfport, MS 39501
Phone (228) 864-2752

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

Interoperability endpoints

  • Direct secure messaging: kgoodfellow@direct.mhg.com

Organizations & group practices 6

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

Hospital & facility affiliations 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1164573515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321359",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392321359",
            "telephone_number": "601-936-1395",
            "fax_number": "601-936-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 REYNOIR ST STE 105",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39530",
            "telephone_number": "228-436-6674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4577 13th St",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395012516",
            "country_code": "US",
            "telephone_number": "228-864-2752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODFELLOW",
        "first_name": "KEITH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "13840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06474210",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.