Organization Active NPI

Robbi a Young DPM PC

  • Podiatrist
  • Grand Haven, MI
National Provider Identifier
1063525533
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901002087 Issued in MI
Legal business name
ROBBI A YOUNG DPM PC
Practice address
600 Park Ave
Grand Haven, MI 49417-2173
Phone
(616) 846-3400
Fax
(616) 846-3406
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Authorized official

Name
Robbi Anne Young, DPMNPI 1992786214
Title
Owner President
Phone
(616) 846-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 5901002087 MI Primary

Addresses

Primary practice location

600 Park Ave
Grand Haven, MI 49417-2173

Mailing address

600 Park Ave
Grand Haven, MI 49417-2173
Phone (616) 846-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061024000076 MI Part B Supplier - Clinic/Group Practice 2466459144 Receives reassigned benefits from 3 practitioners
Practice locations: Grand Haven, MI

National Provider Directory

National Provider Directory

Locations

201 S Beacon Blvd
Grand Haven, MI 49417
Phone (616) 846-3400

600 Park Ave
Ste 3
Grand Haven, MI 49417
Phone (616) 846-3400

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1063525533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PARK AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172173",
            "telephone_number": "616-846-3400",
            "fax_number": "616-846-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PARK AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172173",
            "telephone_number": "616-846-3400",
            "fax_number": "616-846-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBBI A YOUNG DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ROBBI",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "616-846-3400",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901002087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.