Abolhassan Yamin, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20501 Issued in GA

Practice address

8503 Campbellton St
Douglasville, GA 30134-1822

Phone

(770) 949-9985

Fax

(770) 949-6213

NPI assigned

Nov 4, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ayamin2940@choa.gadirect.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.

• Pediatric and Neonatal Clinic, P.C.

  • Specialist
  • Douglasville, GA
  • NPI 1447498944
  NPD (past) Authorized official

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1013908342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8503 CAMPBELLTON ST",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341822",
            "telephone_number": "770-949-9985",
            "fax_number": "770-949-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8503 CAMPBELLTON ST",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341822",
            "telephone_number": "770-949-9985",
            "fax_number": "770-949-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMIN",
        "first_name": "ABOLHASSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "20501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000177449E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mollie Elizabeth Woodard, BS, RBT
• Morine Woodhouse, FNP
• Stacey Candida Woody, CNA
• Jessica Rena Wright-Jennings
• Antoinette Dingle Wright
• Laura M Yancey, RPH
• Brittany York, PHARMD
• Xiangdong You
• Shari Young, RN
• Uranius Young

• Pediatrics Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.