Active NPI
Daniel A Yacono, MD
- Family Medicine Physician
- Albany, GA
National Provider Identifier
1518018738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 30528
- Practice address
- 803 N Jefferson St Ste C
Albany, GA 31701 - Phone
- (229) 312-5800
- Fax
- (229) 312-5853
- NPI assigned
- Jan 15, 2007
- Last updated
- Jun 11, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 058836 | GA | |
| Family Medicine Physician | 207Q00000X | 30528 | NC | Primary |
Addresses
Primary practice location
803 N Jefferson St Ste C
Albany, GA 31701
Mailing address
2511 Old Cornwallis Rd Ste 200
Durham, NC 27713-1869
Phone (919) 932-5700
Other practice location 1
803 N Jefferson St Ste C
Albany, GA 31701-5117
Phone (229) 312-5800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- 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 |
|---|---|---|---|---|
| I20180725001799 | NC | Practitioner - Geriatric Medicine | 0840279907 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 058836 | GA | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoebe Putney Memorial Hospital, Inc. | Past | Accepting new patients | |
| Phoebe Putney Memorial Hospital, Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Phoebe Family Medical Center - Pelham
- Rural Health Clinic/Center
- Pelham, GA
- NPI 1821239765
-
- Rural Health Clinic/Center
- Camilla, GA
- NPI 1821293788
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1518018738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2511 OLD CORNWALLIS RD STE 200",
"city": "DURHAM",
"state": "NC",
"postal_code": "277131869",
"telephone_number": "919-932-5700",
"fax_number": "919-933-6881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 N JEFFERSON ST STE C",
"city": "ALBANY",
"state": "GA",
"postal_code": "31701",
"telephone_number": "229-312-5800",
"fax_number": "229-312-5853"
}
],
"practiceLocations": [
{
"address_1": "803 N Jefferson St Ste C",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "GA",
"postal_code": "317015117",
"country_code": "US",
"telephone_number": "229-312-5800",
"fax_number": "229-312-5853",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YACONO",
"first_name": "DANIEL",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "GA",
"license": "058836",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "30528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.