Keith Porter

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

26479 Issued in MS

Practice address

391 Southcrest Cir Ste 108
Southaven, MS 38671-4775

Phone

(662) 349-2659

NPI assigned

Jun 2, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Anesthesiology

Education

University of Tennessee, HSC, College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Center Anesthesia, IncGroup PAC ID 2769629187, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kporter45104@mlh.direct-ci.com

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.

• Medical Center Anesthesia Inc.

  • Anesthesiology Physician
  • Jackson, TN
  • NPI 1447591730
  Medicare reassignment Care Compare group NPD
• Resource Anesthesiology Associates of TN PC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1316724073

  MS

  Medicare reassignment NPD

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

• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1376923649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 SOUTHCREST CIR STE 108",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714775",
            "telephone_number": "901-830-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 SOUTHCREST CIR STE 108",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714775",
            "telephone_number": "662-349-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "KEITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "26479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetric L Poke, M.A.
• Alejandro Polania
• Samuel C Polk, M.D.
• Jeff Porter, RPH
• Jessica Elizabeth Porter, DPT
• Diosan M Powell, FNP
• Glenn Powell, PHARMD
• Madison J Powell, BA
• Shawanda McGee Powell, LCSW
• Tierany Powell

• Anesthesiology Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Anesthesiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.