NPIMap

Individual provider Active NPI

Yacoba Hudson, MD

  • Family Medicine Physician
  • Woodstock, GA
National Provider Identifier
1912974429
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
044081 Issued in GA
Practice address
9766 Highway 92
Suite 200
Woodstock, GA 30188-6455
Phone
(770) 926-8717
Fax
(770) 916-4820
NPI assigned
Mar 2, 2006
Last updated
Oct 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 044081 GA Primary

Addresses

Primary practice location

9766 Highway 92
Suite 200
Woodstock, GA 30188-6455

Mailing address

PO Box 102321
Atlanta, GA 30368-2321
Phone (770) 801-2500

Other identifiers 1

IdentifierTypeStateIssuer
1912974429OtherGANPI NUMBER

Other names 1

  • Yacoba Sam Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050801000689 GA Practitioner - Family Practice 6507894524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

970 Woodstock Pkwy
Suite 100
Woodstock, GA 30188-4869
Phone (678) 388-5780

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC Family Medicine CurrentSince Feb 8, 2026 Accepting new patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Jan 1, 2012 Accepting new patients
Piedmont Providers LLC Past Accepting new patients

Locations

105 Collier Rd NW
Ste 2070
Atlanta, GA 30309
Phone (404) 350-3860

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

1855 Hudson Bridge Rd
Stockbridge, GA 30281
Phone (678) 565-0648

970 Woodstock Pkwy
Ste 100
Woodstock, GA 30188
Phone (678) 388-5750

9766 Highway 92
Ste 200
Woodstock, GA 30188
Phone (770) 926-8717

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1912974429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102321",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682321",
            "telephone_number": "770-801-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9766 HIGHWAY 92",
            "address_2": "SUITE 200",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886455",
            "telephone_number": "770-926-8717",
            "fax_number": "770-916-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "YACOBA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "044081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1912974429",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YACOBA",
            "last_name": "SAM",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.