Active NPI
Daniel Namkoong, MD
- Family Medicine Physician
- Macon, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 15033
- Practice address
- 3780 Eisenhower Pkwy
Macon, GA 31206-0800 - Phone
- (478) 633-5538
- NPI assigned
- Mar 28, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 103972 | GA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 15033 | GA | Primary |
Addresses
Primary practice location
3780 Eisenhower Pkwy
Macon, GA 31206-0800
Mailing address
777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-5500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4055 Valley View LN
Suite 700
Dallas, TX 75244-4910
4055 Valley View LN
Suite 700
Dallas, TX 75244-5045
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15033 | GA | MD | Family Medicine Physician |
| 103972 | GA | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Services of Central Georgia, Inc | Family Medicine | Current | Accepting new patients |
| Signify Health Medical Associates, PLLC | General Practice | Current | Accepting new patients |
| The Medical Center of Central Georgia Inc | Past | Accepting new patients |
Locations
289 S Culver St
Lawrenceville, GA 30046
Phone (404) 891-9833
777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Interoperability endpoints
- dnamkoong1214665@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Macon, GA
- NPI 1184679482
Family Medicine
-
- General Acute Care Hospital
- Macon, GA
- NPI 1043270564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747785600000",
"number": "1689378341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 HEMLOCK ST",
"city": "MACON",
"state": "GA",
"postal_code": "312012102",
"telephone_number": "478-633-5500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3780 EISENHOWER PKWY",
"city": "MACON",
"state": "GA",
"postal_code": "312060800",
"telephone_number": "478-633-5538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAMKOONG",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-28",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "GA",
"license": "103972",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "15033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.