Individual provider Active NPI

Young Johnathon Lee Yauger, CRNA, RN

  • Certified Registered Nurse Anesthetist
  • Fort Sam Houston, TX
National Provider Identifier
1013049568
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11017215 Issued in FL
Practice address
Brooke Army Medical Center
3551 Roger Brooke Drive
Fort Sam Houston, TX 78234
Phone
(240) 418-2502
NPI assigned
Mar 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R154690 MD
Military Health Care Provider 171000000X APRN11017215 FL
Certified Registered Nurse Anesthetist 367500000X APRN11017215 FL Primary

Addresses

Primary practice location

Brooke Army Medical Center
3551 Roger Brooke Drive
Fort Sam Houston, TX 78234

Mailing address

118 Luther Dr
San Antonio, TX 78212-2017
Phone (240) 418-2502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R154690MDMDRegistered Nurse
APRN11017215FLMDMilitary Health Care Provider

NPI Registry JSON

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1013049568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 LUTHER DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122017",
            "telephone_number": "240-418-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DRIVE",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "240-418-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAUGER",
        "first_name": "YOUNG",
        "middle_name": "JOHNATHON LEE",
        "name_prefix": "Mr.",
        "credential": "CRNA, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-11",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R154690",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "FL",
            "license": "APRN11017215",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11017215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.