Individual provider Active NPI

Brian Jimar Young, MD

  • Pediatrics Physician
  • Kenner, LA
National Provider Identifier
1013198472
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD.203209 Issued in LA
Practice address
200 W. Esplanade Avenue
Kenner, LA 70065-2489
Phone
(504) 464-8588
Fax
(504) 988-6808
NPI assigned
Nov 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X PGY.1.TUL-PEDS LA
Pediatrics Physician 208000000X MD.203209 LA Primary

Addresses

Primary practice location

200 W. Esplanade Avenue
Kenner, LA 70065-2489

Mailing address

1514 Jefferson Highway
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other identifiers 2

IdentifierTypeStateIssuer
1003085MedicaidLA
05378041MedicaidMS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PGY.1.TUL-PEDSLAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Nov 1, 2010 Accepting new patients
Ochsner Clinic LLC CurrentSince Nov 1, 2010 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Correct Care, Inc. CurrentSince Aug 16, 2010 Accepting new patients
Penn Pediatrics Past Accepting new patients

Locations

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

301 Memorial Dr
Donaldsonvlle, LA 70346
Phone (225) 473-7931

200 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-2940

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

1514 Jefferson Hwy
New Orleans, LA 70121

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1013198472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HIGHWAY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000",
            "fax_number": "504-988-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W. ESPLANADE AVENUE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652489",
            "telephone_number": "504-464-8588",
            "fax_number": "504-988-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "BRIAN",
        "middle_name": "JIMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "PGY.1.TUL-PEDS",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.203209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003085",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05378041",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.