NPIMap

Organization Active NPI

Diabetes and Endocrinology Associates, P.C.

  • Specialist
  • Decatur, GA
National Provider Identifier
1659433068
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
046531 Issued in GA
Legal business name
DIABETES AND ENDOCRINOLOGY ASSOCIATES, P.C.
Practice address
2665 North Decatur Rd
Ste 520
Decatur, GA 30033
Phone
(404) 299-2223
NPI assigned
Dec 14, 2006
Last updated
Dec 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Authorized official

Name
Dr. David Harvey Jacobson, M.D.NPI 1487600748
Title
Chief Officer
Phone
(404) 299-2223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X RN127220 GA
Specialist 174400000X 046531 GA Primary

Addresses

Primary practice location

2665 North Decatur Rd
Ste 520
Decatur, GA 30033

Mailing address

2665 North Decatur Rd
Ste 520
Decatur, GA 30033
Phone (404) 299-2223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000507 GA Part B Supplier - Clinic/Group Practice 6608763628 Receives reassigned benefits from 5 practitioners
Practice locations: Decatur, GA; Conyers, GA

National Provider Directory

National Provider Directory

Locations

1366 Wellbrook Cir NE
#A
Conyers, GA 30012
Phone (770) 918-0074

2665 N Decatur Rd
Ste 520
Decatur, GA 30033
Phone (404) 299-2223

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.525008

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 12

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": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262131200000",
    "number": "1659433068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 NORTH DECATUR RD",
            "address_2": "STE 520",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30033",
            "telephone_number": "404-299-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 NORTH DECATUR RD",
            "address_2": "STE 520",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30033",
            "telephone_number": "404-299-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES AND ENDOCRINOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2009-12-30",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "HARVEY",
        "authorized_official_title_or_position": "CHIEF OFFICER",
        "authorized_official_telephone_number": "404-299-2223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "RN127220",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "046531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; 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.