Wayne Matthew Young, OPTOMETRY

Primary specialty

OptometristTaxonomy code 152W00000X

License

5593 T2507 Issued in OH

Practice address

1270 N Bridge St
Chillicothe, OH 45601-1852

Phone

(614) 779-6724

Fax

(740) 779-6727

NPI assigned

Nov 14, 2006

Last updated

Dec 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1003988197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 N BRIDGE ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011852",
            "telephone_number": "614-779-6724",
            "fax_number": "740-779-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 N BRIDGE ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011852",
            "telephone_number": "614-779-6724",
            "fax_number": "740-779-6727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1946 10th Ave N",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295775624",
            "country_code": "US",
            "telephone_number": "843-946-9521",
            "fax_number": "843-916-1481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "WAYNE",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1625",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5593 T2507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica L Young
• Krystal Young, LISW
• Marc Young, RN
• Marilyn Marie Young, LPN
• Paige Young
• Janet Lindsay Younge
• Michael Zamostny, D.O.
• Zane Trace Local School District
• Eliza Zeigler
• Khaleesi Eileen Zeisler

• Optometrist in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.