Individual provider Active NPI

Leonard Wayne Yarbrough

  • Periodontics
  • Montgomery, AL
National Provider Identifier
1578800033
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
3812 Issued in AL
Practice address
1220 Carmichael Way
Montgomery, AL 36106-3671
Phone
(334) 272-7900
Fax
(334) 272-7996
NPI assigned
Jan 3, 2013
Last updated
Apr 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 3812 AL Primary

Addresses

Primary practice location

1220 Carmichael Way
Montgomery, AL 36106-3671

Mailing address

1220 Carmichael Way
Montgomery, AL 36106-3671
Phone (334) 272-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160210000825 AL Order and Referring Only - DentistPractitioner - Dentist 3870897937
I20160215001119 AL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3870897937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
L Wayne Yarbrough DMD Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1578800033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 CARMICHAEL WAY",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063671",
            "telephone_number": "334-272-7900",
            "fax_number": "334-272-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 CARMICHAEL WAY",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063671",
            "telephone_number": "334-272-7900",
            "fax_number": "334-272-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARBROUGH",
        "first_name": "LEONARD",
        "middle_name": "WAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-03",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AL",
            "license": "3812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.