Active NPI
David C Yoburn, M.D.
- Nephrology Physician
- Providence, RI
National Provider Identifier
1346249695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 42706
- Practice address
- 1076 N Main St
Providence, RI 02904-5760 - Phone
- (401) 861-7711
- Fax
- (401) 421-5710
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 42706 | MA | Primary |
Addresses
Primary practice location
1076 N Main St
Providence, RI 02904-5760
Mailing address
18 Bemuth Rd
Newton, MA 02461-1315
Phone (401) 861-7711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7000251 | Medicaid | RI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42706 | MA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463702400000",
"number": "1346249695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 BEMUTH RD",
"city": "NEWTON",
"state": "MA",
"postal_code": "024611315",
"telephone_number": "401-861-7711",
"fax_number": "401-421-5710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1076 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045760",
"telephone_number": "401-861-7711",
"fax_number": "401-421-5710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOBURN",
"first_name": "DAVID",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2016-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MA",
"license": "42706",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7000251",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.