Active NPI
Joel P. Yagoda, O.D.
- Optometrist
- Cartersville, GA
National Provider Identifier
1205974946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1000T
- Practice address
- 101 Market Place Blvd
Cartersville, GA 30121-2236 - Phone
- (770) 386-9022
- NPI assigned
- Feb 2, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1000T | GA | Primary |
Addresses
Primary practice location
101 Market Place Blvd
Cartersville, GA 30121-2236
Mailing address
PO Box 226
Woodstock, GA 30188-0226
Phone (678) 643-8945
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1000 | GA | MD | Clinical Psychologist |
| 1000T | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jumpstart Fitness Inc | Optometrist | Current | Accepting new patients |
| North Park Eye Center P C | Optometrist | Past | Accepting new patients |
Locations
97 Commerce Dr
Blue Ridge, GA 30513
Phone (706) 632-9508
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205974946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 226",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301880226",
"telephone_number": "678-643-8945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MARKET PLACE BLVD",
"city": "CARTERSVILLE",
"state": "GA",
"postal_code": "301212236",
"telephone_number": "770-386-9022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAGODA",
"first_name": "JOEL",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "1000T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cartersville, GA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.