Active NPI
Diabetes and Endocrinology Associates East
- Endocrinology, Diabetes & Metabolism Physician
- Conyers, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- Legal business name
- DIABETES AND ENDOCRINOLOGY ASSOCIATES EAST
- Practice address
- 1501 Milstead Rd NE Ste 100
Conyers, GA 30012-3849 - Phone
- (770) 388-0118
- Fax
- (770) 388-9441
- NPI assigned
- Jun 12, 2019
- Last updated
- Sep 20, 2022
- Organization subpart
- Yes
- Parent organization
- DIABETES AND ENDOCRINOLOGY ASSOCIATES, P.C.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David H Jacobson, M.D.
- Title
- President
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | Primary |
Addresses
Primary practice location
1501 Milstead Rd NE Ste 100
Conyers, GA 30012-3849
Mailing address
2665 N Decatur Rd Ste 520
Decatur, GA 30033-6146
Phone (404) 299-2223
Other practice location 1
2665 N Decatur Rd Ste 520
Decatur, GA 30033-6146
Phone (404) 299-2223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2182672 | Diabetes and Endocrinology Associates East | Certificate of waiver | Apr 23, 2028 |
| 11D2269192 | Diabetes and Endocrinology Associates East | Certificate of waiver | Sep 21, 2026 |
National Provider Directory
National Provider Directory- Part of
- Diabetes Endo Assoc P
Locations
1380 Milstead Ave NE
Ste H
Conyers, GA 30012
Phone (678) 413-1360
2665 N Decatur Rd
Ste 520
Decatur, GA 30033
Phone (404) 299-2223
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Specialist
- Decatur, GA
- NPI 1659433068
Practitioners & affiliated clinicians
Practitioners 20
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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Conyers, GA
- NPI 1043639545
Single Specialty
-
- Endocrinology, Diabetes & Metabolism Physician
- Decatur, GA
- NPI 1487600748
-
- Family Nurse Practitioner
- Decatur, GA
- NPI 1760741904
-
- Primary Care Nurse Practitioner
- Decatur, GA
- NPI 1720719818
-
- Endocrinology, Diabetes & Metabolism Physician
- Decatur, GA
- NPI 1992751259
-
- Nurse Practitioner
- Decatur, GA
- NPI 1750445706
-
- Family Nurse Practitioner
- Decatur, GA
- NPI 1285152132
-
- Medical Physician Assistant
- Decatur, GA
- NPI 1932467479
-
- Nurse Practitioner
- Decatur, GA
- NPI 1417688102
-
- Endocrinology, Diabetes & Metabolism Physician
- Decatur, GA
- NPI 1174570378
-
- Physician Assistant
- Decatur, GA
- NPI 1205652799
-
- Adult Health Nurse Practitioner
- Decatur, GA
- NPI 1578998878
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1663632000000",
"number": "1831758846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2665 N DECATUR RD STE 520",
"city": "DECATUR",
"state": "GA",
"postal_code": "300336146",
"telephone_number": "404-299-2223",
"fax_number": "404-297-5003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 MILSTEAD RD NE STE 100",
"city": "CONYERS",
"state": "GA",
"postal_code": "300123849",
"telephone_number": "770-388-0118",
"fax_number": "770-388-9441"
}
],
"practiceLocations": [
{
"address_1": "2665 N Decatur Rd Ste 520",
"address_purpose": "LOCATION",
"city": "Decatur",
"state": "GA",
"postal_code": "300336146",
"country_code": "US",
"telephone_number": "404-299-2223",
"fax_number": "404-297-5003",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "DIABETES AND ENDOCRINOLOGY ASSOCIATES EAST",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DIABETES AND ENDOCRINOLOGY ASSOCIATES, P.C.",
"enumeration_date": "2019-06-12",
"last_updated": "2022-09-20",
"certification_date": "2022-09-20",
"status": "A",
"authorized_official_last_name": "JACOBSON",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "404-299-2223",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Conyers, GA
- Shakespeare Prince Desir, BABA, MMFT
- Dominique Dessausure, CHIROPRACTOR
- Destined Point Diagnostics
- Developmental & Rehabilitative Services 2, Inc
- Devotionmobilephlebotomyservicesco.LLC
- Christina Diamond
- Tori Didier
- Digital Mammography Specialists - Conyers, LLC
- Gayla Janine Dillard, M.D.
- Divine Case Management Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.