Active NPI
Beryl Gail Yancey, M.D.
- Specialist
- Humboldt, TN
National Provider Identifier
1366471518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 20060
- Practice address
- 3511 Chere Carol Rd
Humboldt, TN 38343-3638 - Phone
- (731) 784-0064
- Fax
- (731) 784-7358
- NPI assigned
- Jul 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 20060 | TN | Primary |
Addresses
Primary practice location
3511 Chere Carol Rd
Humboldt, TN 38343-3638
Mailing address
3511 Chere Carol Rd
Humboldt, TN 38343-3638
Phone (731) 784-0064
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1507997 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040721000053 | TN | Practitioner - Family Practice | 0244210342 | Practice locations: Humboldt, TN |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227139200000",
"number": "1366471518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3511 CHERE CAROL RD",
"city": "HUMBOLDT",
"state": "TN",
"postal_code": "383433638",
"telephone_number": "731-784-0064",
"fax_number": "731-784-7358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3511 CHERE CAROL RD",
"city": "HUMBOLDT",
"state": "TN",
"postal_code": "383433638",
"telephone_number": "731-784-0064",
"fax_number": "731-784-7358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANCEY",
"first_name": "BERYL",
"middle_name": "GAIL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-01",
"last_updated": "2008-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TN",
"license": "20060",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1507997",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Humboldt, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.