Individual provider Active NPI

Kevin Randall Younger, MD

  • Forensic Pathology Physician
  • Fair Oaks, CA
National Provider Identifier
1053447136
Registry record updated Sep 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Pathology PhysicianTaxonomy code 207ZF0201X
License
39996 Issued in KY
Practice address
4836 Skyway Dr
Fair Oaks, CA 95628-6520
Phone
(916) 534-7299
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Pathology Physician 207ZF0201X 39996 KY Primary

Addresses

Primary practice location

4836 Skyway Dr
Fair Oaks, CA 95628-6520

Mailing address

4836 Skyway Dr
Fair Oaks, CA 95628-6520
Phone (916) 534-7299

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
39996KYMDForensic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duckwater Shoshone Tribe Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Organizations & group practices 2

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221955200000",
    "number": "1053447136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4836 SKYWAY DR",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286520",
            "telephone_number": "916-534-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4836 SKYWAY DR",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286520",
            "telephone_number": "916-534-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGER",
        "first_name": "KEVIN",
        "middle_name": "RANDALL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2008-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZF0201X",
            "taxonomy_group": "",
            "desc": "Pathology, Forensic Pathology",
            "state": "KY",
            "license": "39996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.