Individual provider Active NPI

Dustin Cole Horne, MD

  • Family Medicine Physician
  • Jekyll Island, GA
National Provider Identifier
1417420852
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
91054 Issued in GA
Practice address
11 Main St Unit 201
Jekyll Island, GA 31527-1064
Phone
(912) 766-0755
Fax
(912) 766-0775
NPI assigned
Jan 8, 2019
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 91054 GA Primary

Addresses

Primary practice location

11 Main St Unit 201
Jekyll Island, GA 31527-1064

Mailing address

250 Martin Luther King Jr Blvd
Macon, GA 31201-3490

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220913002883 GA Practitioner - Family Practice 5890021497 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

11 Main St
Unit 201
Jekyll Island, GA 31527-1064
Phone (912) 766-0755

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Apr 30, 2024 Accepting new patients
The Corporation of Mercer University Family Medicine CurrentSince Sep 18, 2023 Accepting new patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Apr 30, 2024 Accepting new patients
The Corporation of Mercer University CurrentSince Sep 18, 2023 Accepting new patients
Privia Medical Group, LLC Family Medicine Past Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

11 Main St
Unit 201
Jekyll Island, GA 31527
Phone (912) 766-0755

1550 College St
Macon, GA 31207
Phone (478) 301-2600

250 Mlk Blvd
Macon, GA 31201
Phone (478) 301-2362

Interoperability endpoints

  • Direct secure messaging: dustin.horne.1@8042.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1417420852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MAIN ST UNIT 201",
            "city": "JEKYLL ISLAND",
            "state": "GA",
            "postal_code": "315271064",
            "telephone_number": "912-766-0755",
            "fax_number": "912-766-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNE",
        "first_name": "DUSTIN",
        "middle_name": "COLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "91054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jekyll Island, GA

Sources for this page

Verify at the official NPI Registry.