Young Medical Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

YOUNG MEDICAL CLINIC LLC

Practice address

1302 W Collin Raye Dr Ste a
De Queen, AR 71832-2588

Phone

(870) 642-4730

Fax

(870) 381-7273

NPI assigned

Apr 11, 2012

Last updated

Jun 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel Young, FNP

Title

President

Phone

(870) 642-4730

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1053677377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 W COLLIN RAYE DR STE A",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322588",
            "telephone_number": "870-642-4730",
            "fax_number": "870-381-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 W COLLIN RAYE DR STE A",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322588",
            "telephone_number": "870-642-4730",
            "fax_number": "870-381-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-642-4730",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Williams
• Susan Wingo, MD
• Brittany Winser
• Brianna Wolcott
• Richard D Wolfe, DC

• Family Nurse Practitioner in De Queen, AR
• Providers in De Queen, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.