Individual provider Active NPI

Xiangdong You

  • Internal Medicine Physician
  • Douglasville, GA
National Provider Identifier
1962428870
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
050465 Issued in GA
Practice address
6025 Professional Pkwy
Suite 102
Douglasville, GA 30134-5609
Phone
(770) 489-5000
Fax
(770) 489-0305
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 050465 GA Primary

Addresses

Primary practice location

6025 Professional Pkwy
Suite 102
Douglasville, GA 30134-5609

Mailing address

6025 Professional Pkwy
Suite 102
Douglasville, GA 30134-5609
Phone (770) 489-5000

Other identifiers 17

IdentifierTypeStateIssuer
000934007EMedicaidGA
04-03355OtherGAUHC
201354919OtherGAPHCS
201354919OtherGAMULTIPLAN
21232609899OtherGABEECH STREET
201354919OtherGACOVENTRY
6104OtherGAKAISER
7676325OtherGAAETNA
320129OtherGAWELLCARE OF GEORGIA
52895315OtherGABCBS
P00242355OtherGAMEDICARE RAILROAD
201354919OtherGAHUMANA
201354919OtherGASOUTHCARE
3462913OtherGACIGNA
782253003OtherGAGREAT-WEST
201354919OtherGAHUMANA GOLD CHOICE
2089568OtherGAFIRST HEALTHCARE

Other names 1

  • N/a N/a Other name

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
I20050708000847 GA Practitioner - Internal Medicine 5890721138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4904 Timber Ridge Dr
Suite 303
Douglasville, GA 30135-2888
Phone (770) 489-5000

Hospital & facility affiliations

  • Central Home Health Care, an Amedisys Company Home health agency, Douglasville, GA, CCN 117050
  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Classicare Medical Consult PC, Inc Internal Medicine CurrentSince Jul 1, 2005 Accepting new patients
Leeway Medical Group, P.C. Internal Medicine Past Accepting new patients
Wellstar Health System, Inc. Internal Medicine Past Accepting new patients

Locations

6025 Professional Pkwy
Ste 102
Douglasville, GA 30134
Phone (770) 489-5000

4904 Timber Ridge Dr
Ste 303
Douglasville, GA 30135
Phone (770) 489-5000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DBBCBA/Endpoint/DBBCBA

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.

Hospital & facility affiliations 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1962428870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 PROFESSIONAL PKWY",
            "address_2": "SUITE 102",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345609",
            "telephone_number": "770-489-5000",
            "fax_number": "770-489-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 PROFESSIONAL PKWY",
            "address_2": "SUITE 102",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345609",
            "telephone_number": "770-489-5000",
            "fax_number": "770-489-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOU",
        "first_name": "XIANGDONG",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "050465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000934007E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "04-03355",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "201354919",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "201354919",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECH STREET",
            "identifier": "21232609899",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "201354919",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "6104",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7676325",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF GEORGIA",
            "identifier": "320129",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52895315",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00242355",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "201354919",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHCARE",
            "identifier": "201354919",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3462913",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT-WEST",
            "identifier": "782253003",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GOLD CHOICE",
            "identifier": "201354919",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTHCARE",
            "identifier": "2089568",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.