Individual provider Active NPI

G. Dale Young, N.P.

  • Family Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1043229537
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
046139 Issued in GA
Practice address
565 Old Norcross Rd
Lawrenceville, GA 30046-4308
Phone
(770) 995-5131
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 046139 GA Primary

Addresses

Primary practice location

565 Old Norcross Rd
Lawrenceville, GA 30046-4308

Mailing address

565 Old Norcross Rd
Lawrenceville, GA 30046-4308
Phone (770) 995-5131

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
046139GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David E Kim MD PC PastSince Jul 1, 2019 Accepting new patients
The Healthcaring Clinic of Georgia, LLC Family PastSince May 7, 2013 Accepting new patients
Jae Pak PC PastSince Apr 1, 2014 Accepting new patients
Psychiatric Services of America PastSince Jul 24, 2022 Accepting new patients
Salveo Integrative Health PastSince Jul 24, 2022 Accepting new patients

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1043229537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464308",
            "telephone_number": "770-995-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464308",
            "telephone_number": "770-995-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "G.",
        "middle_name": "DALE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "046139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.