NPIMap

Individual provider Active NPI

Mariella M Young, DC

  • Rehabilitation Chiropractor
  • Rockville, MD
National Provider Identifier
1043421563
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
01979 Issued in MD
Practice address
6137 Executive Blvd
Rockville, MD 20852-3901
Phone
(301) 770-9601
Fax
(301) 770-9540
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01979 MD
Chiropractor 111N00000X 0104555714 VA
Neurology Chiropractor 111NN0400X 01979 MD
Neurology Chiropractor 111NN0400X 0104555714 VA
Rehabilitation Chiropractor 111NR0400X 01979 MD Primary
Rehabilitation Chiropractor 111NR0400X 0104555714 VA
Sports Physician Chiropractor 111NS0005X 01979 MD
Sports Physician Chiropractor 111NS0005X 0104555714 VA
Occupational Health Chiropractor 111NX0100X 01979 MD
Occupational Health Chiropractor 111NX0100X 0104555714 VA
Orthopedic Chiropractor 111NX0800X 01979 MD
Orthopedic Chiropractor 111NX0800X 0104555714 VA

Addresses

Primary practice location

6137 Executive Blvd
Rockville, MD 20852-3901

Mailing address

6137 Executive Blvd
Rockville, MD 20852-3901
Phone (301) 770-9601

Other identifiers 5

IdentifierTypeStateIssuer
10419449OtherMDCAQH
F759-0001OtherDCBCBS
617767OtherMDUNITED HEALTHCARE
M655-0001OtherMDBCBS
478024OtherMDMAMSI

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

State licenses

LicenseStateTypeSpecialty
0104555714VAMDNeurology Chiropractor
01979MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Young Enterprises Chiropractor Past Accepting new patients

Organizations & group practices 1

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1043421563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6137 EXECUTIVE BLVD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523901",
            "telephone_number": "301-770-9601",
            "fax_number": "301-770-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6137 EXECUTIVE BLVD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523901",
            "telephone_number": "301-770-9601",
            "fax_number": "301-770-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARIELLA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01979",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555714",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "MD",
            "license": "01979",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "VA",
            "license": "0104555714",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MD",
            "license": "01979",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "VA",
            "license": "0104555714",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MD",
            "license": "01979",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104555714",
            "primary": false
        },
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "MD",
            "license": "01979",
            "primary": false
        },
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "VA",
            "license": "0104555714",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "MD",
            "license": "01979",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "VA",
            "license": "0104555714",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10419449",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "F759-0001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "617767",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M655-0001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "478024",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.