JEAN ANN M YACCINO D.O.
Complete NPI Record 1376514349
Internal Medicine in Millsboro, DE
Active since January 30, 2006PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Jean Ann M Yaccino, D.O. (NPI 1376514349), an individual internal medicine provider in Millsboro, DE. All 40 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1376514349 Field 1/40
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/40
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: YACCINO Field 3/40
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: JEAN ANN Field 4/40
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: M Field 5/40
- The middle name of the provider, if the provider is an individual.
- Provider Credential Text: D.O. Field 6/40
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 4923 OGLETOWN STANTON RD STE 200 Field 7/40
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: NEWARK Field 8/40
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: DE Field 9/40
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 197132081 Field 10/40
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/40
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 3022250451 Field 12/40
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 3022250472 Field 13/40
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 32050 LONG NECK RD Field 14/40
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: MILLSBORO Field 15/40
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: DE Field 16/40
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 199666228 Field 17/40
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/40
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 3026453150 Field 19/40
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 8339082232 Field 20/40
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 23/40
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 207RN0300X Field 24/40
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: C2-0007702 Field 25/40
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: DE Field 26/40
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 27/40
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 207RN0300X Field 28/40
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: C20007702 Field 29/40
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: DE Field 30/40
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 31/40
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 207R00000X Field 32/40
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 3: C2-0007702 Field 33/40
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 3: DE Field 34/40
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 3: Y Field 35/40
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 1000037835 Field 36/40
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 37/40
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: DE Field 38/40
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: N Field 39/40
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 14
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
34435 King Street Row Ste 1
Location 1/14Lewes, DE 19958-4787 · Phone (302) 645-2833 · Fax (844) 640-3955
23900 Milton Ellendale Hwy Ste 101
Location 2/14Milton, DE 19968-2714 · Phone (302) 684-2033 · Fax (866) 989-3129
32550 Docs Pl Unit 2
Location 3/14Millville, DE 19967-6975 · Phone (302) 539-4302 · Fax (888) 987-4513
232 Mitchell St Unit 301
Location 4/14Millsboro, DE 19966-9412 · Phone (302) 316-4190 · Fax (844) 560-1009
28538 DuPont Blvd Unit 1
Location 5/14Millsboro, DE 19966-4791 · Phone (302) 829-3294 · Fax (833) 314-0538
100 Silicato Pkwy Ste 201
Location 6/14Milford, DE 19963-1273 · Phone (302) 393-2056 · Fax (844) 560-2228
36223 Farm Ln Ste 140
Location 7/14Rehoboth Beach, DE 19971-1329 · Phone (302) 227-1268 · Fax (844) 242-4410
424 Savannah Rd
Location 8/14Lewes, DE 19958-1462 · Phone (302) 645-3150 · Fax (833) 908-2232
12100 Black Swan Dr Ste 104
Location 9/14Lewes, DE 19958-4991 · Phone (302) 645-1315 · Fax (833) 437-1399
17388 N Village Main Blvd Unit 21
Location 10/14Lewes, DE 19958-7240 · Phone (302) 291-6050 · Fax (833) 450-5311
21635 Biden Ave Unit 101
Location 11/14Georgetown, DE 19947-4575 · Phone (302) 856-9596 · Fax (888) 987-4164
18947 John J Williams Hwy Unit 303
Location 12/14Rehoboth Beach, DE 19971-4477 · Phone (302) 644-0690 · Fax (844) 242-4410
36450 Tidal Rd Unit 2
Location 13/14Selbyville, DE 19975-4596 · Phone (302) 291-6045 · Fax (833) 449-3867
1008 Kings Hwy
Location 14/14Lewes, DE 19958-1932 · Phone (302) 291-6031 · Fax (833) 954-4028
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
1000037835 Medicaid
Identifier 1/1State: DE
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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