Kenyon McGill Fort, D.D.S.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

DN0012496 Issued in FL

Practice address

7135 Dr. M. L. King Jr., Street North
St. Petersburg, FL 33702

Phone

(727) 525-5455

Fax

(727) 525-7223

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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 FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

Other, 1989

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kfort189477@orlandohealth.medalliesdirect.net

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.

• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  NPD
• Comfortable Care Denta Health Professionals, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • St Petersburg, FL
  • NPI 1962162883

  Oral and Maxillofacial Pathology

  NPD (past)

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

• Ohi West, Inc

  • General Acute Care Hospital
  • St Petersburg, FL
  • NPI 1154399749
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396830741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7135 DR. M. L. KING JR., STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-525-5455",
            "fax_number": "727-525-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7135 DR. M. L. KING JR., STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-525-5455",
            "fax_number": "727-525-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORT",
        "first_name": "KENYON",
        "middle_name": "MCGILL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "FL",
            "license": "DN0012496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Forester, LCSW
• Adrienne Forkois, OT
• Shawnte W Forrer, BS
• Amanda Tollon Forsman, OTD, OTR/L
• Amy Fort
• Prem Fort, MD
• Ellen R Fortier, PA
• Danielle Fortner, DC
• Forward Physical Therapy, LLC
• Jennifer Fosdick, APRN

• Oral and Maxillofacial Pathology Dentistry in St. Petersburg, FL
• Providers in St. Petersburg, FL by specialty
• Oral and Maxillofacial Pathology Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.