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KEON ANDERSON D.D.S.
NPI 1891178539
Dentist - General Practice in Fort Worth, TX

Active since June 30, 2015PECOS Enrolled
100 N LAMAR ST, FORT WORTH, TX 76196(817) 702-3567(817) 569-1421 Get Directions Write a Review

NPPES record last updated: October 3, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 3, 2018, Feb 1, 2016 (2 updates tracked since 2016).

About Keon Anderson D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEON ANDERSON D.D.S. (NPI 1891178539) is an individual general practice provider in Fort Worth, Texas, licensed in Texas (31042) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891178539
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameKEON ANDERSONCredential: D.D.S.
Location Address100 N LAMAR STFort Worth, TX 76196-0216
Mailing AddressPo Box 732973Dallas, TX 75373-2973 · (817) 702-2450
Phone(817) 702-3567
Fax(817) 569-1421
Sole ProprietorNo
Enumeration DateJune 30, 2015
Last NPPES UpdateOctober 3, 20182 updates tracked since enumeration
✔ NPI 1891178539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TX · 31042
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
100 N LAMAR ST, Fort Worth, TX 76196
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Keon Anderson D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Keon Anderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Acclaim Physician Group, Inc
2.0 mi
Internal Medicine
1500 S MAIN ST
Fort Worth, TX 76104
  • Reassigned Medicare billing, Texas enrollment
  • 985 clinicians in this Medicare group
NPI 1780076562 (817) 702-6770

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76196 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES BREGG REEDY PA-C
Physician Assistant
100 N LAMAR ST
FORT WORTH, TX 76196
Tarrant County (817) 884-3204
MR. TOLANI ADEYEMI OLABODE
Psychiatry & Neurology (Psychiatry)
100 N LAMAR ST
FORT WORTH, TX 76196
Tarrant County (214) 862-1203
PATRICIA WRIGHT LVN
Licensed Vocational Nurse
100 N LAMAR ST
FORT WORTH, TX 76196
Tarrant County (817) 335-3022
JAMES RUCKER MS
Counselor (Professional)
100 N LAMAR ST
FORT WORTH, TX 76196
Tarrant County (817) 335-3022
DANA MICHELLE GOGGANS PA
Physician Assistant
100 N LAMAR ST
FORT WORTH, TX 76196
Tarrant County (817) 248-6209
KELSEY RICE PA-C
Physician Assistant
100 N LAMAR ST
FORT WORTH, TX 76196
Tarrant County (817) 248-6209
MIKAELA BRAUNE PA
Physician Assistant
100 N LAMAR ST
FORT WORTH, TX 76196
Tarrant County (817) 702-3567
BRITNEY MARTIN PA
Physician Assistant
100 N LAMAR ST
FORT WORTH, TX 76196
Tarrant County (817) 702-3567

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keon Anderson's NPI number?

The NPI number for Keon Anderson is 1891178539. It was assigned to this individual provider in the NPPES registry on June 30, 2015.

Where is Keon Anderson located?

Keon Anderson practices at 100 N Lamar St, Fort Worth, TX 76196. The listed phone number is (817) 702-3567.

What is Keon Anderson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Keon Anderson enrolled in Medicare?

Yes. Keon Anderson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Keon Anderson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keon Anderson reassigns Medicare benefits to Acclaim Physician Group, Inc (Fort Worth, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Keon Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Keon Anderson accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 4 other insurers list Keon Anderson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Keon Anderson was last updated on October 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.