Edmond Michael Young, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

112656 Issued in MO

Practice address

305 NW Englewood CT #300
Gladstone, MO 64118

Phone

(816) 453-7473

Fax

(816) 453-1940

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

Yes

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 MO

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

Psychiatry

Education

University of Kansas School of Med (KC/Wich/Sal), 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Psychiatric Associates, LLCGroup PAC ID 0345153581, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Comprehensive Psychiatric Associates, LLC

  • Psychiatry Physician
  • Gladstone, MO
  • NPI 1891821120
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053424838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NW ENGLEWOOD CT #300",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64118",
            "telephone_number": "816-453-7473",
            "fax_number": "816-453-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 NW ENGLEWOOD CT #300",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "64118",
            "telephone_number": "816-453-7473",
            "fax_number": "816-453-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "EDMOND",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "112656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Woodbine Healthcare LLC
• Wyllie Chiropractic, PC
• Bennett Micah Wyllie
• James A Wyllie, D.C., D.A.B.C.O.
• James Kent Wyllie, D.C.
• Aileen Bausa Zuccarini, OTR/L

• Psychiatry Physician in Gladstone, MO
• Providers in Gladstone, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.