Organization Active NPI

Dr Bill Yates MD PC

  • General Practice Physician
  • Jasper, AL
National Provider Identifier
1629276845
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
10923 Issued in AL
Legal business name
DR BILL YATES MD PC
Practice address
203 19TH St E
Jasper, AL 35501-5457
Phone
(205) 384-3481
Fax
(205) 384-1057
NPI assigned
Jul 10, 2007
Last updated
Aug 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Authorized official

Name
Dr. Bill Yates, M.D.NPI 1043312101
Title
Doctor
Phone
(205) 384-3481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 10923 AL Primary

Addresses

Primary practice location

203 19TH St E
Jasper, AL 35501-5457

Mailing address

203 19TH St E
Jasper, AL 35501-5457
Phone (205) 384-3481

Other identifiers 2

IdentifierTypeStateIssuer
529302220MedicaidAL
51085092OtherALBLUE CROSS & BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040706000085 AL Part B Supplier - Clinic/Group Practice 4981681251 Receives reassigned benefits from 1 practitioner
Practice locations: Carbon Hill, AL

National Provider Directory

National Provider Directory

Locations

31040 1st Ave NE
Ste 6B
Carbon Hill, AL 35549
Phone (205) 384-3481

203 19th St E
Jasper, AL 35501
Phone (205) 384-3481

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1629276845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 19TH ST E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355015457",
            "telephone_number": "205-384-3481",
            "fax_number": "205-384-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 19TH ST E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355015457",
            "telephone_number": "205-384-3481",
            "fax_number": "205-384-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BILL YATES MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "YATES",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "205-384-3481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "10923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529302220",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "51085092",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.