NPI age
11 years
Enumerated 2014-06-02
● Active
Type 1 · Individual
Mio Yanagisawa
Yanagisawa is 1 of 15 surgery providers in Fayetteville and 1 of 1389 in Georgia.
Primary specialty
Surgery
Plus 2 subspecialties
Licensed in
GA, PA
2 states
Status
Active
No deactivations on record
Last NPPES update
2025-11-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1389 active surgery providers in Georgia.
NPI age
11 years
↓ 6 yr below median (17 yr)
State licenses
2 states
Top 85% — 14% of peers are multi-state
Subspecialties
1
In the 28% of peers with subspecialties
NPI lifetime · 2014 → 2026
2014-06Enumerated in NPPES
2014
2026
Where they practice
Practice location
1279 Highway 54 W Ste 100
Fayetteville, GA 302144551
Mailing address
1365 Clifton Rd Ne Bldg C
Atlanta, GA 303221013
Additional practice locations
4 secondary locations on file with NPPES.
Location 2
22 St Paul Dr Ste 207
Chambersburg, PA 172011036
Location 3
1365 Clifton Rd Ne Bldg C
Atlanta, GA 303221013
Location 4
450 S Washington St
Gettysburg, PA 173252500
Location 5
2315 Stockton Blvd
Sacramento, CA 958172201
Specialties
-
Surgery PrimaryA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and...
-
Student in an Organized Health Care Education/Training ProgramAn individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 925717241 | PPS |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.