Individual provider Active NPI

Eric Leon Yancey, M.D.

  • Surgery Physician
  • Mullins, SC
National Provider Identifier
1417960360
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35245 Issued in SC
Practice address
119 W Lowman St
Mullins, SC 29574-3107
Phone
(843) 464-4000
Fax
(843) 464-4017
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101223145 VA
Surgery Physician 208600000X 35245 SC Primary

Addresses

Primary practice location

119 W Lowman St
Mullins, SC 29574-3107

Mailing address

119 W Lowman St
Mullins, SC 29574-3107
Phone (843) 464-4000

Other identifiers 2

IdentifierTypeStateIssuer
010118271MedicaidVA
175116OtherVAANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050301000416 VA Practitioner - General Surgery 5890748958 Reassigns benefits to 1 organization

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35245SCMDSurgery Physician
0101223145VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yameika Surgical Group, P.C. PastSince Dec 1, 2004 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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1417960360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W LOWMAN ST",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295743107",
            "telephone_number": "843-464-4000",
            "fax_number": "843-464-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W LOWMAN ST",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295743107",
            "telephone_number": "843-464-4000",
            "fax_number": "843-464-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANCEY",
        "first_name": "ERIC",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101223145",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "35245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010118271",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "175116",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullins, SC

Sources for this page

Verify at the official NPI Registry.