Individual provider Active NPI

Anthony Yawn, NP

  • Nurse Practitioner
  • Dublin, GA
National Provider Identifier
1225070261
Registry record updated Oct 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN104649 Issued in GA
Practice address
1110 Hillcrest Pkwy
Dublin, GA 31021-3687
Phone
(478) 296-2800
Fax
(478) 296-2801
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN104649 GA Primary

Addresses

Primary practice location

1110 Hillcrest Pkwy
Dublin, GA 31021-3687

Mailing address

PO Box 16100
Dublin, GA 31040-6100
Phone (478) 296-2800

Other identifiers 1

IdentifierTypeStateIssuer
571021614BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN104649GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Souza Family Health & Urgent Care Center, LLC PastSince Sep 1, 2008 Accepting new patients
Sterling Emergency Services of the Southeast Inc Nurse Practitioner Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256256000000",
    "number": "1225070261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16100",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310406100",
            "telephone_number": "478-296-2800",
            "fax_number": "478-296-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 HILLCREST PKWY",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213687",
            "telephone_number": "478-296-2800",
            "fax_number": "478-296-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAWN",
        "first_name": "ANTHONY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2009-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN104649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "571021614B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2009; 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.