Individual provider Active NPI

Thomas Young, M.D.

  • Cardiovascular Disease Physician
  • Dothan, AL
National Provider Identifier
1083694665
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
209032311 Issued in IL
Practice address
1150 Ross Clark Cir
Dothan, AL 36301-3022
Phone
(334) 712-1929
Fax
(334) 712-2799
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 209032311 IL Primary
Cardiovascular Disease Physician 207RC0000X 16584 AL

Addresses

Primary practice location

1150 Ross Clark Cir
Dothan, AL 36301-3022

Mailing address

1150 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 712-1929

Other practice location 1

4600 Memorial Dr Ste W1
Belleville, IL 62226-5359
Phone (618) 233-3066

Other identifiers 12

IdentifierTypeStateIssuer
009942275MedicaidAL
051088715OtherALBLUE CROSS
370489101MedicaidFL
000088715MedicaidAL
051095000OtherALBLUE CROSS
051055300OtherALBLUE CROSS
370489100MedicaidFL
00505689BMedicaidGA
051540112OtherALBLUE CROSS
370489102MedicaidFL
631087996OtherTAX ID#
61700OtherFLBLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL, GA, IL4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20110216000931 AL Practitioner - Cardiovascular Disease (Cardiology) 3072558683 Reassigns benefits to 2 organizations
I20111228000093 FL Practitioner - Cardiovascular Disease (Cardiology) 3072558683 Reassigns benefits to 1 organization
I20120105000480 GA Practitioner - Cardiovascular Disease (Cardiology) 3072558683 Reassigns benefits to 4 organizations
I20250919000190 IL Practitioner - Cardiovascular Disease (Cardiology) 3072558683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1404 Cross St
Shiloh, IL 62269-2988
Phone (618) 607-3055

1418 Cross St
Suite 350
Shiloh, IL 62269-2988
Phone (618) 607-3900

19 Doctors Way
Suite C
Blairsville, GA 30512-1117
Phone (706) 439-6380

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

4600 Memorial Dr
Belleville, IL 62226-5359

Hospital & facility affiliations

  • Memorial Hospital Hospital, Belleville, IL, CCN 140185
  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • Union General Hospital Hospital, Blairsville, GA, CCN 110051
  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16584ALMDCardiovascular Disease Physician
209032311ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Cardiovascular Disease CurrentSince Sep 13, 1995 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia CurrentSince Jul 1, 2021 Accepting new patients
Southeast Cardiology Clinic Inc. Cardiovascular Disease CurrentSince Aug 5, 1993 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Jun 14, 2025 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia CurrentSince Jul 1, 2021 Accepting new patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Jan 29, 2024 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Jun 14, 2025 Accepting new patients
Donalsonville Hospital Inc CurrentSince Apr 7, 2017 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1150 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-2770

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

409 N Main St
Ste A
Enterprise, AL 36330

3700 Williams Dr
Marianna, FL 32446
Phone (850) 482-9200

19 Doctors Way
Ste C
Blairsville, GA 30512
Phone (706) 439-6380

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

102 Hospital Cir
Donalsonville, GA 39845
Phone (229) 524-8489

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4600 Memorial Dr
Ste W1
Belleville, IL 62226
Phone (618) 233-3066

5213 Godfrey Rd
Ste 110
Godfrey, IL 62035
Phone (618) 619-3330

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433

Interoperability endpoints

  • Direct secure messaging: tyoung63319@sgmc.gadirect.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1083694665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-712-1929",
            "fax_number": "334-712-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
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            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013022",
            "telephone_number": "334-712-1929",
            "fax_number": "334-712-2799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Memorial Dr Ste W1",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622265359",
            "country_code": "US",
            "telephone_number": "618-233-3066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "209032311",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "16584",
            "primary": false
        }
    ],
    "identifiers": [
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            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009942275",
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        },
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            "issuer": "BLUE CROSS",
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            "issuer": null,
            "identifier": "370489101",
            "state": "FL"
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            "issuer": null,
            "identifier": "000088715",
            "state": "AL"
        },
        {
            "code": "01",
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            "issuer": "BLUE CROSS",
            "identifier": "051095000",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051055300",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370489100",
            "state": "FL"
        },
        {
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            "issuer": null,
            "identifier": "00505689B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051540112",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370489102",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "631087996",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "61700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5213 Godfrey Rd Ste 110",
            "city": "Godfrey",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620352510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.