Individual provider Active NPI

Daniel Namkoong, MD

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1689378341
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15033 Issued in GA
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

Updated by the provider on May 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260116002918 GA Practitioner - General Practice 6709246770 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
15033GAMDFamily Medicine Physician
103972GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Central Georgia, Inc Family Medicine CurrentSince Apr 6, 2023 Accepting new patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Oct 1, 2025 Accepting new patients
The Medical Center of Central Georgia Inc PastSince Apr 6, 2023 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.