Douglas Trent Young, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA636 Issued in NV

Practice address

2845 Siena Heights Dr
Henderson, NV 89052-4153

Phone

(702) 617-1227

Fax

(702) 492-1589

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Agata-Venger Partnership

  • Neurological Surgery Physician
  • Las Vegas, NV
  • NPI 1093772204
  NPD (past)
• Linda L. Johnson MD, LTD

  • Adult Medicine Physician
  • Henderson, NV
  • NPI 1376838110
  NPD (past)
• Southwest Medical Associates Inc.

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
  • NPI 1174607303
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1003889577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-242-7786",
            "fax_number": "702-240-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 SIENA HEIGHTS DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524153",
            "telephone_number": "702-617-1227",
            "fax_number": "702-492-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "DOUGLAS",
        "middle_name": "TRENT",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002402368",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003889577",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allen Young, MD
• Audrey Young
• Canesha Denitres Young
• Codero Young
• Deidra Young
• Gabrielle Young
• Jonet R Young
• Keyonah Young
• Kristen Haunani Young, PT, DPT
• Megan Kuniko Young, MA, OTR/L

• Medical Physician Assistant in Henderson, NV
• Providers in Henderson, NV by specialty
• Medical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.