DR. JACOB CARMEN YANNETTA III (NPI# 1992873046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992873046 |
| Entity Type | Individual |
| Full Name | DR. JACOB CARMEN YANNETTA III |
| Credential | D.O. |
| Practice Address |
2141 N Fairfield Rd Ste. B Beavercreek OH 45431-2578 |
| Practice Telephone | 9374580025 |
| Practice Fax Number | 9374580212 |
| Mailing Telephone | 9374580025 |
| Mailing Fax Number | 9374580212 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2012-06-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 34.008653 | OH | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
34008653 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2774869 | 05 |
| Street Address |
2141 N FAIRFIELD RD STE. B |
| City | BEAVERCREEK |
| State | OH |
| Zip Code | 45431-2578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396225793 | Rebecca Anne Reynolds | Nurse Practitioner | 2141 N Fairfield Rd, Ste B, Beavercreek, OH 45431-2579 | 2018-08-16 |
| 1730461047 | Alliance Physician Inc | Surgery | 2141 N Fairfield Rd, Suite B, Beavercreek, OH 45431-2579 | 2011-09-13 |
| 1679752570 | Dayton Cardiology Consult | Specialist | 2141 N Fairfield Rd, Beavercreek, OH 45431-2578 | 2007-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336768571 | Seth Perry | Student in an Organized Health Care Education/Training Program | Soin Family Medicine, 2145 North Fairfield Road, Suite 100, Beavercreek, OH 45431 | 2020-04-08 |
| 1326680133 | Beavercreek Dental Care Inc | Clinic/Center | 2141 N Fairfield Rd Suite A, Beavercreek, OH 45431 | 2019-10-14 |
| 1487213955 | Hannah Sutherland | Dentist | 3286 Pentagon Park Blvd, Beavercreek, OH 45431 | 2019-06-10 |
| 1598232027 | Holly M Williams | Speech-Language Pathologist | 3038 Kemp Road, Beavercreek, OH 45431 | 2018-11-02 |
| 1770987711 | Tisha Alcorn | Home Health Aide | 327 Canova Ln., Dayton, OH 45431 | 2014-10-20 |
| 1619389301 | Peyman Fattahi | Dentist | 3286 Pentagon Park Blvd., Beavercreek, OH 45431 | 2014-05-29 |
| 1497182992 | Trista Muncy | Social Worker | 100 Elmwood Park Drive Suite 201, Dayton, OH 45431 | 2013-09-30 |
| 1871869636 | Liberty Nursing Center of Beavercreek Inc | Skilled Nursing Facility | 3854 Park Overlooke Drive, Beavercreek, OH 45431 | 2012-03-27 |
| 1750650776 | Emergency Medicine Specialists, Inc | Emergency Medicine | 3535 Pentagon Boulevard, Beavercreek, OH 45431 | 2011-12-20 |
| 1902079213 | Laureene Bollinger | Registered Nurse | 2286 El Cid Dr., Beavercreek, OH 45431 | 2008-04-08 |
| Find all providers in zip 45431 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114041126 | Alberto Jose Lopez | Surgery | 4447 Somerset Path, Beavercreek, OH 45440-4419 | 2007-03-16 |
| 1730461047 | Alliance Physician Inc | Surgery | 2141 N Fairfield Rd, Suite B, Beavercreek, OH 45431-2579 | 2011-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659993459 | Matt Thompson | Surgery | Department of Vascular Surgery 9500 Euclid Avenue, Cleveland, OH 44195-0001 | 2020-05-14 |
| 1194373704 | Premier Vein and Vascular Care LLC | Surgery | 33290 Bainbridge Rd, Solon, OH 44139-2802 | 2019-08-27 |
| 1588144299 | Garcia Vascular Surgery Center, LLC | Surgery | 29099 Health Campus Dr Ste 380, Westlake, OH 44145-5276 | 2018-08-21 |
| 1962900365 | Marilyn Mcnamara | Surgery | 1031 Brook Ln, Rocky River, OH 44116-2184 | 2018-01-31 |
| 1386155521 | Zanesville Vascular Vein & Wound Center LLC | Surgery | 3964 Frazeysburg Rd Unit A, Zanesville, OH 43701-8920 | 2017-10-16 |
| 1679026751 | Center for Vein Restoration Oh, LLC | Surgery | 1050 Isaac Streets Dr Ste 131, Oregon, OH 43616-8203 | 2016-07-26 |
| 1235541640 | Jon Garrett Quatromoni | Surgery | Mail Code F30 9500 Euclid Avenue, Cleveland, OH 44195-4238 | 2014-05-20 |
| 1881035343 | Innovative Wound Care Associates, Inc | Surgery | 790 Boardman Canfield Rd Ste 3, Boardman, OH 44512-4344 | 2013-07-12 |
| 1184062242 | Jorge Enrique Motta | Surgery | 12268 Church Rd, Orrville, OH 44667-9623 | 2013-06-11 |
| 1912245853 | Cleveland East Vascular Care, LLC | Surgery | 23650 Commerce Park Ste B, Beachwood, OH 44122-5817 | 2013-01-28 |
| Find all providers with the same taxonomy | ||||
| City | BEAVERCREEK |
| Zip Code | 45431 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.