NPIMap

Individual provider Active NPI

Theodore Leon Yarboro Jr., MD

  • Family Medicine Physician
  • Sandersville, GA
National Provider Identifier
1114979499
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37929 Issued in GA
Practice address
610 Sparta Rd
Sandersville, GA 31082-1860
Phone
(478) 240-2125
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 037929 GA
Family Medicine Physician 207Q00000X 37929 GA Primary

Addresses

Primary practice location

610 Sparta Rd
Sandersville, GA 31082-1860

Mailing address

465 Plantation Dr
Sandersville, GA 31082-7453
Phone (478) 552-6787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20040713000372 GA Practitioner - Family PracticePractitioner - Emergency Medicine 9830177146 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Pittsburgh School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southland Consolidated Emergency Services LLCGroup PAC ID 2860792066, 68 clinicians
Southland Hawkinsville Emergency Medical Services, LLCGroup PAC ID 2769600642, 13 clinicians

Practice addresses (Care Compare)

1500 E Shotwell St
Bainbridge, GA 39819-4256
Phone (229) 246-3500

222 Perry Hwy
Hawkinsville, GA 31036-6748
Phone (229) 200-4950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37929GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Consolidated Emergency Services, LLC Emergency Medicine CurrentSince Oct 1, 2019 Accepting new patients
Southland Cochran Emergency Medical Services, LLC Emergency Medicine CurrentSince Oct 19, 2019 Accepting new patients
Southland Taylor Hospitalist Group, LLC CurrentSince Aug 29, 2022 Accepting new patients
Southland Burke Emergency Medical Services, LLC Emergency Medicine CurrentSince Oct 4, 2022 Accepting new patients
Southland Emergency Medical Services Consolidated, LLC Family Medicine CurrentSince May 30, 2020 Accepting new patients
Southland Hawkinsville Emergency Medical Services, LLC Emergency Medicine CurrentSince Oct 19, 2019 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
McRae Emergency Physcians LLC Emergency Medicine Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients
McRae Emergency Services, LLC Emergency Medicine Past Accepting new patients
Dodge Emergency Group LLC Emergency Medicine Past Accepting new patients
Evans Emergency Group LLC Emergency Medicine Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients

Locations

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527

222 Perry Hwy
Hawkinsville, GA 31036
Phone (229) 200-4950

1067 Peachtree St
Louisville, GA 30434
Phone (478) 625-7000

610 Sparta Rd
Sandersville, GA 31082
Phone (478) 240-2000

351 S Liberty St
Waynesboro, GA 30830
Phone (706) 554-4435

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1114979499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 PLANTATION DR",
            "city": "SANDERSVILLE",
            "state": "GA",
            "postal_code": "310827453",
            "telephone_number": "478-552-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SPARTA RD",
            "city": "SANDERSVILLE",
            "state": "GA",
            "postal_code": "310821860",
            "telephone_number": "478-240-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARBORO",
        "first_name": "THEODORE",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "037929",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "37929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandersville, GA

Sources for this page

Verify at the official NPI Registry.