Lisa Ann Young, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

88683 Issued in GA

Practice address

1 Magnolia CT
Moultrie, GA 31768-6764

Phone

(229) 502-9769

Fax

(928) 338-5508

NPI assigned

Jun 2, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Arizona College of Osteopathic Medicine Mid Western University, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Butte Indian Health Service HospitalGroup PAC ID 7517852759, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment Care Compare group NPD
• DHHS IHS Phoenix Area

  • Critical Access Hospital
  • Polacca, AZ
  • NPI 1356628028

  Family Medicine, TX

  Medicare reassignment NPD
• DHHS IHS Phoenix Area

  • General Acute Care Hospital
  • Whiteriver, AZ
  • NPI 1427335140

  TX

  Medicare reassignment NPD
• Fort Yates Indian Health Service Hospital

  • Critical Access Hospital
  • Fort Yates, ND
  • NPI 1609851039

  TX

  Medicare reassignment
• DHHS IHS Phoenix Area

  • Clinic/Center
  • Cibecue, AZ
  • NPI 1427335181
  NPD
• Colquitt Regional Surgery, LLC

  • Surgery Physician
  • Moultrie, GA
  • NPI 1902213846
  NPD (past)
• Essentia Health Virginia, LLC

  • Multi-Specialty Clinic/Center
  • Ely, MN
  • NPI 1962440362
  NPD (past)

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1043446222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860",
            "address_2": "WHITERIVER IHS",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "85941",
            "telephone_number": "928-338-4911",
            "fax_number": "928-338-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAGNOLIA CT",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686764",
            "telephone_number": "229-502-9769",
            "fax_number": "928-338-5508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Sweet Bay Ct",
            "address_purpose": "LOCATION",
            "city": "Moultrie",
            "state": "GA",
            "postal_code": "317686784",
            "country_code": "US",
            "telephone_number": "229-985-2198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3131 S Main St",
            "address_purpose": "LOCATION",
            "city": "Moultrie",
            "state": "GA",
            "postal_code": "317686925",
            "country_code": "US",
            "telephone_number": "229-985-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2021-10-05",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "88683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Taylor Wooldridge, FNP-C
• Stephen Yarbrough, DO
• Peggy Yates
• Paul Yermachenkov
• Daniel Rae York, DO
• Ali Zain Ul Abideen
• Helen Darlene Zebley, N.P.
• Wenhui Zhu, MD

• Family Medicine Physician in Moultrie, GA
• Providers in Moultrie, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.